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Updated: Jan 9, 2026

Fertility Preservation in Patients with Severe Ovarian Dysfunction
Published on: March 25, 2021
Options for Final Oocyte Maturation Trigger: Can the Ovarian Response Prediction Index (ORPI) Guide the Optimal
Jose G Franco Junior1, Claudia G Petersen1, Joao Bosco Meziara1
1Center for Human Reproduction Prof. Franco Jr - Ribeirão Preto, SP, Brazil.
Abstract:
Dual triggering is recommended in most cases with GnRH antagonists for final oocyte maturation. Although no definitive data support the routine use of dual triggering in normal responders, recent meta-analyses have indicated benefits linked to dual triggering regarding improved reproductive outcomes (oocyte maturation, embryo quality, and clinical pregnancy). Therefore, dual triggering may be considered the preferred trigger for all patients undergoing IVF with antagonist blockade cycles (ORPI in ranges A and B (without hCG dose reduction) and in cases of ORPI in ranges C and D (with hCG dose reduction). Finally, rigorous clinical assessment is essential when an isolated GnRHa trigger is combined with low-dose hCG to correct an inadequate luteal phase. In these cases, the freezing all protocol cannot be ignored.
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