{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T15:33:21Z","timestamp":1783784001059,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":321,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005421","name":"Guilan University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005421","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Reprod Medicine &amp; Biology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The optimal GnRH agonist (GnRHa) dosing for ovulation triggering remains controversial, particularly regarding oocyte competence versus OHSS mitigation. Here, we analyzed the repeated dose of GnRHa as a trigger of ovulation on intracytoplasmic sperm injection (ICSI) results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010blinded randomized clinical trial was conducted on 362 ICSI candidates who met the inclusion criteria. The subjects underwent the antagonist protocol and based on the received trigger, were divided into two groups: single dose (group A) and repeated dose (group B) of GnRHa. Demographic and clinical data were collected and analyzed using SPSS\u201024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Repeated dosing of GnRH increased M2 oocyte numbers yield by 22.84%\u2009\u00b1\u20096.92% (95% CI: 9.23\u201325.38,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Also, the maturity rate (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), the number of pronuclear embryos (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), and the number of good and excellent quality embryos (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) were higher in group B. Empty follicle syndrome was presented in no cases. Despite the high ovarian response, no OHSS cases were reported (mean oocytes&gt;\u200917\u2009\u00b1\u20098). There was no significant difference regarding premature ovulation, use of Cabergoline, chemical and clinical pregnancy, miscarriage, and live birth rates between the 2 study groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It seems that the administration of the second dose of GnRHa 12\u2009h after the first dose leads to better oocyte maturation and higher quality embryos.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trail Registration<\/jats:title>\n                    <jats:p>\n                      IRCT20081007001306N11;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/irct.behdasht.gov.ir\/trial\/60387\">https:\/\/irct.behdasht.gov.ir\/trial\/60387<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/rmb2.12690","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T09:31:54Z","timestamp":1763458314000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Trigger Effect of\n                    <scp>GnRH<\/scp>\n                    Agonist Repeated Dose on Intracytoplasmic Sperm Injection Outcomes: A Randomized Single\u2010Blinded Clinical Trial"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5746-4269","authenticated-orcid":false,"given":"Ziba","family":"Zahiri Sorouri","sequence":"first","affiliation":[{"name":"Reproductive Health Research Center, Department of Obstetrics &amp; Gynecology, Al\u2010Zahra Hospital, School of Medicine Guilan University of Medical Sciences  Rasht Iran"},{"name":"Mehr Fertility Research Center Guilan University of Medical Sciences  Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5829-4036","authenticated-orcid":false,"given":"Mohadese","family":"Mehdinia","sequence":"additional","affiliation":[{"name":"Reproductive Health Research Center, Department of Obstetrics &amp; Gynecology, Al\u2010Zahra Hospital, School of Medicine Guilan University of Medical Sciences  Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6274-0088","authenticated-orcid":false,"given":"Saeed","family":"Alborzi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research Center Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6270-129X","authenticated-orcid":false,"given":"Atoosa","family":"Etezadi","sequence":"additional","affiliation":[{"name":"Reproductive Health Research Center, Department of Obstetrics &amp; Gynecology, Al\u2010Zahra Hospital, School of Medicine Guilan University of Medical Sciences  Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8891-7264","authenticated-orcid":false,"given":"Zahra","family":"Haghparast ghadim\u2010limudahi","sequence":"additional","affiliation":[{"name":"Reproductive Health Research Center, Department of Obstetrics &amp; Gynecology, Al\u2010Zahra Hospital, School of Medicine Guilan University of Medical Sciences  Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4035-2890","authenticated-orcid":false,"given":"Ehsan","family":"Kazemnezhad Leyli","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Health, Road Trauma Research Center Guilan University of Medical Science  Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-024-01211-z"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-71-4-918"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deac114"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13048-024-01465-6"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.683210"},{"issue":"1","key":"e_1_2_11_7_1","first-page":"48","article-title":"Can We Harvest More Mature Oocytes by Repeating Gonadotropin\u2010Releasing Hormone Agonist Doses in Polycystic Ovarian Syndrome Patients at Risk of OHSS in Antagonist Cycles? 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