Outcomes Comparison of In-Vitro Fertilization (IVF) between GnRH Agonist Trigger and hCG for Final Oocyte Maturation


Introduction: For decades, human chorionic gonadotropin (hCG) has been used for final oocyte maturation. It is proven to have highest life birth rate, comparing to gonadotropin releasing hormone (GnRH) agonist, but unfortunately it can increases the risk of developing ovarian hyper stimulation syndrome (OHSS). There is an ongoing debate over the optimal agent that can trigger final oocyte maturation in antagonist protocol, leading to higher IVF success rate without increasing the risk of OHSS.

Objective: To compare IVF outcomes in patient using GnRH agonist trigger and hCG for final oocyte maturation.

Method: A retrospective review of in vitro fertilization patient at Daya Medika Clinic and Yasmin Clinic.

Result: 76 women were analyzed consist of 38 women using GnRH agonist and 38 women using hCG. We found no significant differences on biochemical pregnancy rate (24.00% and 20.51%) between two group, but there were significant differences on fertilization rate (67.72% and 61.32%),  cleavage rate (95.04% and 88.92%) and blastocyst rate (13.90% and 7.38%). There was one patient developed OHSS in hCG group

Conclusion: GnRH agonists can be considered for use as a trigger final oocyte maturation in the antagonist protocol because some IVF outcomes data showed that GnRH agonists triggering were better than hCG without increasing the risk of OHSS