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Updated: Oct 19, 2025

Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives
Published on: September 16, 2021
Dual trigger protocol is an effective in vitro fertilization strategy in both normal and high responders without
Rebecca K Chung1, Abigail C Mancuso2, Karen M Summers2
1Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Objective:
To study the birth rates of normal vs. high responders after dual trigger of final oocyte maturation with gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin in fresh in vitro fertilization (IVF) cycles in which ovarian stimulation was achieved by a flexible GnRH antagonist protocol.
Design:
Retrospective cohort study.
Setting:
University hospital.
Patients:
In women <35 years of age, 290 fresh IVF cycles using the dual trigger protocol with day 5 embryo transfers from January 2013 to July 2018 were included. Cycles excluded were those with preimplantation genetic testing, gestational carriers, donor oocytes, and fertility preservation.
Interventions:
IVF with dual trigger.
Main Outcome Measures:
Clinical pregnancy rate, live birth rate.
Results:
Comparing normal responders, defined as <30 oocytes retrieved, and high responders, defined as ≥30 oocytes retrieved, the clinical pregnancy rates (67.0% vs. 69.3%, respectively) and live birth rates (60.5% vs. 60.0%, respectively) were not significantly different. No cases of ovarian hyperstimulation syndrome were reported in either group.
Conclusions:
Ovarian stimulation by a flexible GnRH antagonist protocol followed by dual trigger yields comparable outcomes between normal and high responders in fresh IVF cycles.
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