Gnrh Agonist Trigger Versus Hcg Trigger in Gnrh Antagonist in Ivf/Icsi Cycles: A Review Article

Routinely, a bolus of 5.000-10.000 iu human chorionic gonadotropin (hcg) is usedfor the final follicular maturation and ovulation as a standard method. hcg has thesame effect of luteinizing hormone (lh) with long half-life. it has the longlutheotrophic effect which increases the risk of ovarian hyper stimulation syndrome(ohss). recently, gonadotropin-releasing hormone agonist (gnrh-a) trigger hasbeen used for the induction of final follicular maturation and ovulation with the aimof reducing the ohss risk. several studies have shown that the releases ofendogenous follicular stimulating hormone (fsh) and lh after administration ofgnrh agonist in in vitro fertilization (ivf) cycles are able to precede the finalfollicular maturation leading to removal of fertile oocyte with normal developmentof the embryo and ultimately pregnancy. but based on the results of some studies,using gnrh-a trigger leads to defect luteal-phase resulting to reduce theimplantation and clinical pregnancy rates and also increase abortion in fresh embryotransfer cycles compared to routine ivf cycle with hcg triggering . also, in recentyears, studies have continued to modify the luteal phase support, so that the freshembryo transfer is possible too. in this review, we examined the benefits, problems,and also ways to reform gnrh agonist triggering complications