Equivalent live-birth rate in antagonist IVF/ICSI protocol after oocyte triggering with GnRH agonist supplemented with 1500 r-hCG the day of oocyte retrieval vs r-hCG : A case-control study.

OBJECTIVE: To compare live birth rate after fresh transfer and cumulative birth rates after vitrified embryo transfer in patients triggered by GnRHa, and 1500 r-hCG bolus on the day of the pick up to a selected population of patients triggered by r-hCG.

DESIGN: Retrospective case-control study SETTING: Private hospital, Rennes, France PATIENTS: Patients with more than 18 follicles greater than 11 mm on the day of the triggering, or patients with a history of OHSS INTERVENTION: We triggered according to the European protocol by GnRHa and a bolus of 1500 UI of r-HCG on the day of the pick-up and performed if possible a fresh transfer on day 2, 3 or 5.

MAIN OUTCOME MEASURE: The live birth rate using fresh transfer (FT) and the cumulative birth rate by cycle of FT and frozen embryo transfer (FET) between patients triggered by GnRHa with a bolus injection of 1500 r-hCG and patients triggered by r-hCG.

RESULTS: Patients triggered by GnRHa and supplemented with a bolus injection of 1500 IU r-hCG one hour after the pick up had FT birth rates equivalent to those seen after r-hCG triggering: 32.0% vs 31.8% (p = 0.9687). There was a non significant trend for better results for cumulative birth rates in FT + FET after agonist triggering.

CONCLUSION: Our approach proposed may be suitable as an alternative to freeze all in centers where embryonic vitrification is not optimal, and for patients for whom freeze all is not possible for legal or ethical reasons.