Comparison of Triggering Final Oocyte Maturation with Follicle Stimulating Hormone Plus Human Chorionic Gonadotropin, versus Human Chorionic Gonadotropin Alonein Normoresponder Women Undergoing Intracytoplasmic Sperm Injection: A Randomized Clinical Trial

BACKGROUND: Few studies have so far been done about the role of follicle stimulating hormone (FSH) in final oocyte maturation. However, none of these studies have been performed solely on normoresponder patients. This study aimed to determine whether oocyte maturation, as well as fertilization and pregnancy rates, could be improved in normoresponder women with concomitant FSH and human chorionic gonadotropin (hCG) trigger compared to those with the hCG trigger alone. MATERIALS AND METHODS: In this prospective randomized clinical trial, 117 normoresponder women, aged 19-40 years who were candidates for the gonadotropin-releasing hormone (GnRH) antagonist protocol at Avicenna Infertility treatment Center, were enrolled and claasified in two groups. Final oocyte maturation was triggered using 10000 IU of hCG plus 450 IU of FSH in the first group (59 subjects) and 10000 IU of hCG alone in the second group (58 subjects). The primary outcome was clinical pregnancy rate. RESULTS: Mean age of the patients was 33.21 ± 4.41 years. There was no difference in clinical pregnancy among the two groups (30.9% vs. 25.5%, P=0.525). There was no statistically significant difference in fertilization rate (80.0% vs. 74.1%, P=0.106), implantation rates (18.9% vs. 16.7%, P=0.352), and chemical pregnancy rates (38.2% vs. 32.7%, P=0.550). Oocyte maturation rate (84.2% vs. 73.6%, P<0.001), 2 pronuclei (2PNs) (6.53 ± 2.54 vs. 5.36 ± 2.85, P=0.021) and total embryos (5.85 ± 2.43 vs. 4.91 ± 2.58, P=0.046) were significantly higher in the first group. CONCLUSION: Adding FSH to hCG for oocyte triggering, significantly improved oocyte maturation rates and total embryos. While there was no significant difference in the clinical and chemical pregnancy rates, between these two groups (registration number: IRCT20190108042285N1).