Abstract：
During the in vitro fertilization treatment, human chorionic gonadotrophin (hCG) is routinely used as a substitute for the natural endogenous LH surge during the final stage of oocyte maturation. However, it does not provide the FSH surge observed in the mid-cycle of the natural cycle. To date, whether the FSH surge can improve oocyte quality and pregnancy outcomes remains unknown. Randomized controlled trials comparing the following four trigger methods to conventional hCG were examined: GnRH agonist (GnRHa), kisspeptin, GnRHa plus hCG (dual trigger), and FSH plus hCG (FSH co-trigger). The results showed that the use of dual triggers was associated with a significantly higher number of retrieved cumulus-oocyte complexes (COCs) (weighted mean difference [WMD] 1.625, 95% CI 0.684-2.565), retrieved mature oocytes (WMD 0.986, 95% CI 0.426-1.545) and fertilized (2PN) oocytes (WMD 0.792, 95% CI 0.083-1.501), compared with the use of hCG. However, there was no significant difference between the two groups in terms of pregnancy rate. The FSH co-trigger resulted in significantly higher rates of 2PN oocytes retrieved than the hCG trigger (WMD 0.077, 95% CI 0.028-0.126). Notably, the risk of OHSS did not differ among the three treatment groups compared to that of the hCG group. This review protocol was registered with PROSPERO (CRD 42020194201).
摘要：
在体外受精治疗期间，在卵母细胞成熟的最后阶段，人绒毛膜促性腺激素（hCG）通常被用作天然内源性LH激增的替代品。然而,它不提供在自然周期中期观察到的FSH激增。迄今为止,FSH升高是否能改善卵母细胞质量和妊娠结局尚不清楚.比较以下四种触发方法与常规hCG的随机对照试验：GnRH激动剂（GnRHa），kisspeptin,GnRHa加hCG（双触发），和FSH加hCG（FSH协同触发剂）。结果表明，使用双重触发因素与检索到的卵丘-卵母细胞复合体（COCs）的数量显着增加相关（加权平均差[WMD]1.625，95％CI0.684-2.565），回收的成熟卵母细胞（WMD0.986，95%CI0.426-1.545）和受精（2PN）卵母细胞（WMD0.792，95%CI0.083-1.501），与使用HCG相比。然而,两组妊娠率无显著差异。与hCG触发剂相比，FSH协同触发剂导致2PN卵母细胞的回收率明显更高（WMD0.077，95％CI0.028-0.126）。值得注意的是,与hCG组相比,3个治疗组的OHSS风险无差异.本综述方案在PROSPERO(CRD42020194201)注册。
