{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T11:28:14Z","timestamp":1786361294593,"version":"build-2736575974"},"reference-count":32,"publisher":"King Faisal Specialist Hospital and Research Centre","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Saudi Med"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Unexplained infertility remains a diagnostic and therapeutic challenge. Dual trigger, combining gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG), has been proposed to more closely mimic the physiological mid-cycle gonadotropin surge than hCG alone in gonadotropin-stimulated intrauterine insemination (IUI) cycles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To evaluate whether dual trigger improves biochemical pregnancy outcomes compared with hCG-only trigger in gonadotropin-stimulated IUI cycles<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN:<\/jats:title>\n                    <jats:p>Retrospective cohort study<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTINGS:<\/jats:title>\n                    <jats:p>Single-center, tertiary referral center<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS AND METHODS:<\/jats:title>\n                    <jats:p>\n                      Between April 2021 and September 2022, 96 patients underwent IUI after ovarian stimulation with gonadotropins (53 hCG-only, 43 dual trigger). Baseline demographic and clinical characteristics included female age (29.5\u00b12.5 vs. 27.2\u00b13.5 years), male age (33.3\u00b14.0 vs. 31.6\u00b13.5 years), body mass index (BMI) (24.0 vs. 25.0 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), gonadotropin dose (median 675 IU), treatment duration (median 9 days), dominant follicle size (18 mm vs. 17 mm), and endometrial thickness (9 mm vs. 8 mm).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MAIN OUTCOME MEASURES:<\/jats:title>\n                    <jats:p>Biochemical pregnancy, defined as serum \u03b2-hCG \u22655 mIU\/mL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SAMPLE SIZE:<\/jats:title>\n                    <jats:p>96 patients (53 hCG-only, 43 dual trigger)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Biochemical pregnancy occurred in 18.6% of the dual trigger group and 11.3% of the hCG-only group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =.315). The odds of biochemical pregnancy were higher with dual trigger but not statistically significant (OR=1.8, 95% CI: 0.6\u20135.6). Subgroup analysis revealed a significant association between infertility duration and biochemical pregnancy (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =.04), with 76.9% of conceptions occurring in women with 2\u20133 years of infertility.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Dual trigger did not significantly improve biochemical pregnancy rates compared with hCG-only trigger (OR=1.8, 95% CI: 0.6\u20135.6). Infertility duration was the only significant predictor of treatment success. Larger multi-center trials are required due to the current study's limited power.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS:<\/jats:title>\n                    <jats:p>Retrospective design, single-center setting, and limited sample size may restrict generalizability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5144\/0256-4947.2026.295","type":"journal-article","created":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T04:19:25Z","timestamp":1786249165000},"page":"295-303","source":"Crossref","is-referenced-by-count":0,"title":["Biochemical pregnancy outcomes following dual versus human chorionic gonadotropin-only trigger in gonadotropin-stimulated intrauterine insemination cycles for unexplained infertility: a retrospective cohort study"],"prefix":"10.5144","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3156-2527","authenticated-orcid":true,"given":"Mehtap Akin","family":"Efe","sequence":"first","affiliation":[{"name":"From the Istanbul Faculty of Medicine, Istanbul Universitesi, Fatih, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozlem","family":"Dural","sequence":"additional","affiliation":[{"name":"From the Istanbul Faculty of Medicine, Istanbul Universitesi, Fatih, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hevra Ekin","family":"Ulusoy","sequence":"additional","affiliation":[{"name":"From the Istanbul Faculty of Medicine, Istanbul Universitesi, Fatih, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atacem Mert","family":"Aytekin","sequence":"additional","affiliation":[{"name":"From the Istanbul Faculty of Medicine, Istanbul Universitesi, Fatih, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cemil","family":"Akg\u00fcl","sequence":"additional","affiliation":[{"name":"From the Istanbul Faculty of Medicine, Istanbul Universitesi, Fatih, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3134","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.06.005"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000450"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2010.06.031"},{"issue":"2","key":"e_1_3_3_5_2","doi-asserted-by":"crossref","first-page":"143","DOI":"10.21613\/GORM.2020.1034","article-title":"Comparison of hCG Versus Gonadotropin-Releasing Hormone Agonist to Induce Oocyte Maturation in Assisted Reproductive Technology Cycles: A Retrospective Cohort Study","volume":"27","author":"Nacak GB","year":"2021","unstructured":"Nacak GB, Tozkir E, Ozkaya E, Cogendez E, Kaya F. 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