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A randomized Clinical Trial comparing embryo quality and clinical pregnancy rate in PCOS patients underwent controlled ovarian stimulation using antagonist protocol with freeze all strategy and triggered for final oocyte maturation by gonadotropin agonist versus human chorionic gonadotropin in IVF cycles

Obstetrics & Gynecology International Journal
Wafaa Ramadan,1 Mahmoud Alalfy,2 Rania Refaat3


Background: The use of Gonadotropin-releasing hormone (GnRH) antagonist protocol rather than the long agonist protocol showed a marked reduction in the incidence of OHSS
Aim: To compare the effect of triggering oocytes by agonist versus HCG on reduction of risk of OHSS, embryo quality and clinical pregnancy rate.
Patients and methods: A randomized Clinical Trial was conducted at IVF unit in Cairo University Obstetric and Gynecologic hospital.
The patients were divided into two groups, the 1st group received GnRH agonist trigger, the 2nd group received hCG trigger; all embryos were frozen at day 5 and frozen embryos were transferred the next cycle.
Results: There was an obvious reduction in the risk of OHSS in the GnRH agonist triggered group than in the HCG triggered group but with no statistically significant difference.
In the current study, there was no statistically significant difference between the HCG triggered group in comparison to the GnRH agonist triggered group regarding chemical and clinical pregnancy rates.
Conclusion: The use of GnRH triggering for women with PCOS undergoing ICSI cycle with antagonist protocol with freeze all and transfer of frozen embryos in a later cycle has a lower risk of OHSS than using HCG triggering method.


Pregnancy, Antagonist protocol, Ovarian stimulation, Oocyte maturation