Author(s)

Mohamed Elmahdy^*, Suzan Elsharkawy

Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Objectives: The aim of the study was to compare the efficacy and safety of GnRH-agonist to the human chorionic gonadotrophin (HCG) trigger in cases of simple ovarian stimulation. Study design: Randomized controlled trial was conducted on 291 women complaining of unexplained infertility visiting Elshatby Maternity University Hospital from February to December 2019. Trial registration unique ID is PACTR202001787868341 (https://www.pactr.org/). Age included from 20 - 43 years. All patients were stimulated by the sequential stimulation protocol using letrozole then FSH injection, when the criteria of ovulation trigger were reached; cases were randomized into two groups using closed envelopes method. Group A (123 cases) GnRh agonist (triptorelin 0.2 IU) subcutaneous injection and Group B (168 cases) HCG 10,000 IU intramuscular injection were used for triggering of ovulation then followed by timed intercourse. Results: Primary outcome was the clinical pregnancy rate while rate of miscarriage and ovarian hyper-stimulation rate were the secondary outcome. Clinical pregnancy rates, in Group A were (21.1%) while it was (31.5%) in another group (P = 0.049). Miscarriage rate was (4.9%) in the first group and (3.6%) in the second group (P = 0.580). Except for one case of moderate ovarian hyper-stimulation syndrome (OHSS) complicated the HCG group, there were no such cases in GnRH group. Conclusion: Triggering final oocyte maturation with HCG was superior to GnRH agonists triggers as regards the clinical pregnancy rate.

GnRH Agonist, HCG, Ovulation Trigger, OHSS

Elmahdy, M. and Elsharkawy, S. (2021) GnRH-Agonist Trigger versus Human Chorionic Gonadotrophin (HCG) Trigger in Cases of Controlled Ovarian Stimulation; Randomized Controlled Trial. Open Journal of Obstetrics and Gynecology, 11, 1452-1460. doi: 10.4236/ojog.2021.1111135.