{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T20:57:21Z","timestamp":1780433841726,"version":"3.54.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T00:00:00Z","timestamp":1621900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\u201cDual triggering\u201d for final oocyte maturation using a combination of a gonadotropin-releasing hormone agonist (GnRHa) and human chorionic gonadotropin (hCG) can improve clinical outcomes in high responders during <jats:italic>in vitro<\/jats:italic> fertilization\u2013intracytoplasmic sperm injection (IVF\u2013ICSI) GnRH-antagonist cycles. However, whether this dual trigger is also beneficial to normal responders is not known. We retrospectively analyzed the data generated from 469 normal responders from 1 January to 31 December 2017. The final oocyte maturation was undertaken with a dual trigger with a GnRHa combined with hCG (<jats:italic>n<\/jats:italic> = 270) or hCG alone (<jats:italic>n<\/jats:italic> = 199). Patients were followed up for 3 years. The cumulative live-birth rate was calculated as the first live birth achieved after all cycles having an embryo transfer (cycles using fresh embryos and frozen\u2013thawed embryos) among both groups. Women in the dual-trigger group achieved a slightly higher number of oocytes retrieved (11.24 vs. 10.24), higher number of two-pronuclear (2PN) embryos (8.37 vs. 7.67) and a higher number of embryos available (4.45 vs. 4.03). However, the cumulative live-birth rate and the all-inclusive success rate for assisted reproductive technology was similar between the two groups (54.07 vs. 59.30%). We showed that a dual trigger was not superior to a hCG-alone trigger for normal responders in GnRH-antagonist cycles in terms of the cumulative live-birth rate.<\/jats:p>","DOI":"10.3389\/fmed.2021.683210","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T04:32:36Z","timestamp":1621917156000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":23,"title":["Effect of a \u201cDual Trigger\u201d Using a GnRH Agonist and hCG on the Cumulative Live-Birth Rate for Normal Responders in GnRH-Antagonist Cycles"],"prefix":"10.3389","volume":"8","author":[{"given":"Fumei","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanbin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuxiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumeng","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjing","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1016\/j.fertnstert.2007.07.1316","article-title":"Can pregnancy rate be improved in gonadotropin-releasing hormone (GnRH) antagonist cycles by administering GnRH agonist before oocyte retrieval? A prospective, randomized study","volume":"90","author":"Schachter","year":"2008","journal-title":"Fertil Steril."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2517","DOI":"10.1016\/j.fertnstert.2010.12.054","article-title":"Effect of GnRH agonist and hCG treatment on VEGF, angiopoietin-2, and VE-cadherin: trying to explain the link to ovarian hyperstimulation syndrome","volume":"95","author":"Cerrillo","year":"2011","journal-title":"Fertil Steril."},{"key":"B3","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1210\/jcem-71-4-918","article-title":"Use of gonadotropin-releasing hormone agonist to trigger follicular maturation for in vitro fertilization","volume":"71","author":"Gonen","year":"1990","journal-title":"J Clin Endocrinol Metab."},{"key":"B4","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/S0015-0282(16)54474-4","article-title":"Induction of preovulatory luteinizing hormone surge and prevention of ovarian hyperstimulation syndrome by gonadotropin-releasing hormone agonist","volume":"56","author":"Itskovitz","year":"1991","journal-title":"Fertil. Steril."},{"key":"B5","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.rbmo.2012.11.002","article-title":"GnRH agonist triggering: recent developments","volume":"26","author":"Kol","year":"2013","journal-title":"Reprod Biomed Online."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2887","DOI":"10.1093\/humrep\/dei150","article-title":"A lower ongoing pregnancy rate can be expected when GnRH agonist is used for triggering final oocyte maturation instead of HCG in patients undergoing IVF with GnRH antagonists","volume":"20","author":"Kolibianakis","year":"2005","journal-title":"Human Reprod"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.1093\/humrep\/deh765","article-title":"GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF\/ICSI cycles: a prospective randomized study","volume":"20","author":"Humaidan","year":"2005","journal-title":"Hum Reprod"},{"key":"B8","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.fertnstert.2007.06.030","article-title":"Gonadotropin-releasing hormone agonist combined with a reduced dose of human chorionic gonadotropin for final oocyte maturation in fresh autologous cycles of in vitro fertilization","volume":"90","author":"Shapiro","year":"2008","journal-title":"Fertil Steril."},{"key":"B9","doi-asserted-by":"publisher","first-page":"2715","DOI":"10.1016\/j.fertnstert.2011.03.109","article-title":"Comparison of \u201ctriggers\u201d using leuprolide acetate alone or in combination with low-dose human chorionic gonadotropin","volume":"95","author":"Shapiro","year":"2011","journal-title":"Fertil Steril."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1316","DOI":"10.1016\/j.fertnstert.2012.03.015","article-title":"Dual trigger of oocyte maturation with gonadotropin-releasing hormone agonist and low-dose human chorionic gonadotropin to optimize live birth rates in high responders","volume":"97","author":"Griffin","year":"2012","journal-title":"Fertil Steril."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1016\/j.fertnstert.2013.07.1976","article-title":"Dual trigger with combination of gonadotropin-releasing hormone agonist and human chorionic gonadotropin significantly improves the live-birth rate for normal responders in GnRH-antagonist cycles","volume":"100","author":"Lin","year":"2013","journal-title":"Fertil Steril."},{"key":"B12","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1002\/ijgo.12457","article-title":"Comparison of dual trigger with combination GnRH agonist and hCG versus hCG alone trigger of oocyte maturation for normal ovarian responders","volume":"141","author":"Zhou","year":"2018","journal-title":"Int J Gynaecol Obstetr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"300","DOI":"10.5653\/cerm.2020.03804","article-title":"Dual trigger in normally-responding assisted reproductive technology patients increases the number of top-quality embryos","volume":"47","author":"S\u00fck\u00fcr","year":"2020","journal-title":"Clin Exp Reprod Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1016\/S0015-0282(00)00518-5","article-title":"Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer","volume":"73","author":"Gardner","year":"2000","journal-title":"Fertil Steril."},{"key":"B15","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1016\/j.rbmo.2010.06.031","article-title":"LH (as HCG) and FSH surges for final oocyte maturation: sometimes it takes two to tango?","volume":"21","author":"Kol","year":"2010","journal-title":"Reprod Biomed Online."},{"key":"B16","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1093\/humupd\/dmv059","article-title":"GnRH and GnRH receptors in the pathophysiology of the human female reproductive system","volume":"22","author":"Maggi","year":"2016","journal-title":"Hum Reprod Update."},{"key":"B17","doi-asserted-by":"publisher","first-page":"101728","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 trial","volume":"49","author":"Ali","year":"2020","journal-title":"J Gynecol Obstetr Hum Reprod."},{"key":"B18","doi-asserted-by":"publisher","first-page":"101","DOI":"10.4103\/0974-1208.183506","article-title":"Evaluation of dual trigger with gonadotropin-releasing hormone agonist and human chorionic gonadotropin in improving oocyte maturity rates: a prospective randomized study","volume":"9","author":"Mahajan","year":"2016","journal-title":"J Hum Reprod Sci."},{"key":"B19","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1186\/1472-6874-12-27):27","article-title":"Comparison of hCG triggering versus hCG in combination with a GnRH agonist: a prospective randomized controlled trial","volume":"6","author":"Decleer","year":"2014","journal-title":"Facts Views Vision Obstetr Gynnaecol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.mefs.2018.01.001","article-title":"Final oocyte maturation with a dual trigger compared to human chorionic gonadotropin trigger in antagonist co-treated cycles: a randomized clinical trial","volume":"23","author":"Alleyassin","year":"2018","journal-title":"Middle East Fertil Soc J."},{"key":"B21","first-page":"63","article-title":"Combined administration of gonadotropin-releasing hormone agonist with human chorionic gonadotropin for final oocyte maturation in GnRH antagonist cycles for in vitro fertilization","volume":"59","author":"Kim","year":"2014","journal-title":"J Reprod Med."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.683210\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T04:32:39Z","timestamp":1621917159000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.683210\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,25]]},"references-count":21,"alternative-id":["10.3389\/fmed.2021.683210"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2021.683210","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,25]]},"article-number":"683210"}}