{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:48:31Z","timestamp":1792511311497,"version":"4.5.0"},"reference-count":29,"publisher":"Bioscientifica","issue":"4","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>This double-blind randomized clinical trial compared recombinant human chorionic gonadotropin (rhCG) alone with dual triggering (gonadotropin-releasing hormone agonist plus rhCG) for final oocyte maturation in women with endometriosis and poor ovarian response (Bologna criteria) undergoing intracytoplasmic sperm injection. A total of 152 eligible women were randomized (1:1) to receive either rhCG (250 \u03bcg) plus placebo (n = 76) or rhCG (250 \u03bcg) plus GnRH agonist (0.2 mg; n = 76). Ultimately, 128 participants completed the protocol through embryo transfer (per-protocol cohort: n = 65 rhCG, n = 63 dual trigger). The primary outcome was the number of retrieved metaphase II (MII) oocytes; secondary outcomes included embryo quality and pregnancy rates. The dual-trigger group yielded significantly more MII oocytes (6.53 \u00b1 4.61 vs 4.14 \u00b1 2.91; effect size (ES) = 0.63, 95% CI: 0.30\u20130.95; P &amp;lt; 0.001) and Grade A embryos (0.66 \u00b1 0.82 vs 0.37 \u00b1 0.62; ES = 0.39, 95% CI: 0.05\u20130.73; P = 0.023). Per-protocol chemical pregnancy (38.1 vs 15.4%; relative risk of success (RR) = 2.48, 95% CI: 1.29\u20134.75; P = 0.004) and clinical pregnancy rates (38.1 vs 10.8%; RR = 3.54, 95% CI: 1.64\u20137.62; P &amp;lt; 0.001) were significantly higher following dual triggering, with consistent findings in intention-to-treat analyses. Dual triggering significantly enhances oocyte maturity, embryo quality, and clinical pregnancy outcomes compared with rhCG monotherapy in poor responders with endometriosis; larger multicenter trials are warranted to corroborate these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay summary<\/jats:title>\n                    <jats:p>Women with endometriosis often face difficulty becoming pregnant, especially when their ovaries produce only a small number of eggs. In assisted fertility treatments, hormones are used to help eggs mature before they are collected. One common method uses a hormone called hCG, whereas another approach, known as dual triggering, combines hCG with an additional hormone to better mimic the body\u2019s natural process. In this study, we compared these two methods in 152 women with endometriosis and poor ovarian response undergoing fertility treatment. We found that women who received the two-hormone method produced more fully mature eggs and more good-quality embryos, and had higher pregnancy rates than those who received hCG alone. These findings suggest that using both hormones may offer a better chance of success for some women with endometriosis undergoing fertility treatment and could help doctors tailor treatment to individual patient needs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/raf-25-0215","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:31:38Z","timestamp":1790260298000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-13","source":"Crossref","is-referenced-by-count":0,"title":["Recombinant hCG versus dual triggering for final oocyte maturation in ICSI cycles among poor responders with endometriosis"],"prefix":"10.1530","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3834-2420","authenticated-orcid":true,"given":"Fatemeh","family":"Davari Tanha","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Yas Hospital, Tehran University of Medical Sciences 1 , ,","place":["Tehran, Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4722-7635","authenticated-orcid":true,"given":"Mahbod","family":"Ebrahimi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Yas Hospital, Tehran University of Medical Sciences 1 , ,","place":["Tehran, Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7370-9083","authenticated-orcid":true,"given":"Zahra","family":"Kaveh","sequence":"additional","affiliation":[{"name":"School of Medicine, Tehran University of Medical Sciences 2 , ,","place":["Tehran, Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Feizabad","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences 3 , ,","place":["Tehran, Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0232-6177","authenticated-orcid":true,"given":"Shirin","family":"Zarrinjooie","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Yas Hospital, Tehran University of Medical Sciences 1 , ,","place":["Tehran, Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakimeh","family":"Roshani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Yas Hospital, Tehran University of Medical Sciences 1 , ,","place":["Tehran, Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8655-0174","authenticated-orcid":true,"given":"Shima","family":"Rahimi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Yas Hospital, Tehran University of Medical Sciences 1 , ,","place":["Tehran, Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4100-0875","authenticated-orcid":true,"given":"Elham","family":"Rashidi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Yas Hospital, Tehran University of Medical Sciences 1 , ,","place":["Tehran, Iran"]},{"name":"4 Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"2026102011264665000_bib1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jogoh.2020.101728","article-title":"Dual trigger using recombinant HCG and gonadotropin-releasing hormone agonist improve oocyte maturity and embryo grading for normal responders in GnRH antagonist cycles: randomized controlled 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