Evaluation of dual-trigger regimen in improving outcomes for pregnancy in different ovarian respond patients: a retrospective study

Objective: Observing pregnancy outcomes of patients who used dual-trigger and single-trigger regimens in different ovarian responders who received ART, and assessing the effectiveness and safety of the regimens to provide insights into the optimization of clinical strategy. Methods The clinical profile of 2778 infertile patients who received ART (IVF/ICSI) were reviewed and collected retrospectively. Patients enrolled with different ovarian responses were divided into single-trigger and dual-trigger groups based on different real-world trigger protocols. The baseline characteristics, ovulation induction and pregnancy outcomes of the patients were statistically analyzed. Results There were no significant differences in characteristics of the baseline and cycle parameters on the two trigger regimen groups for high responders, normal responders and low responders. The number of oocytes and the oocytes retrieval rate by the dual trigger of normal responders and high responders have increased, but there were no significant differences in pregnancy outcomes (embryo transfer rate, pregnancy rate, live birth rate) between trigger groups. The dual trigger had a lower transplant cancellation rate due to prevention of OHSS: high responders (P = 0.927), normal responders (P = 0.251). In poor responders, there were no cases of transplantation cancellation for OHSS prevention in both groups. Conclusion The dual trigger is a relatively effective and safe regimen for patients with high response and normal ovarian response. In patients with poor ovarian response, the evidence for reducing the risk of OHSS is not sufficient. Further validation in larger, well-designed randomized controlled trials on whether dual triggering improves pregnancy outcomes in poor responders is needed.