Triggering final follicular maturation for IVF cycles.

Area of Science:

• Reproductive Endocrinology
• Infertility Treatments
• Assisted Reproductive Technologies

Background:

• Controlled ovarian hyperstimulation (COH) commonly uses human chorionic gonadotropin (hCG) for final follicular maturation.
• GnRH agonist (GnRHa) trigger with GnRH antagonist co-treatment is used to mitigate ovarian hyperstimulation syndrome and enhance oocyte/embryo yield.
• Combining GnRHa with hCG trigger is a recent clinical approach.

Purpose of the Study:

• To analyze and discuss published studies on various methods for triggering final follicular maturation.
• To elucidate the appropriateness of different triggering approaches for specific patient subgroups in COH.

Main Methods:

• Systematic review and discussion of published literature.
• Analysis of studies comparing different final maturation trigger protocols in COH.

Main Results:

• Evaluation of the efficacy and safety of hCG versus GnRHa triggering.
• Assessment of combined GnRHa and hCG trigger protocols.
• Identification of patient subgroups that may benefit from specific triggering strategies.

Conclusions:

• Different triggering strategies for final follicular maturation in COH have distinct advantages and disadvantages.
• The choice of trigger (hCG, GnRHa, or combination) should be individualized based on patient characteristics and treatment goals.
• Optimizing trigger selection can improve COH outcomes, including oocyte yield, embryo quality, and safety.