Suboptimal Mature Oocyte Yield in Antagonist Icsi Cycles: Any Impact of the Ovulation Triggering Agent?

Abstract PURPOSE OF RESEARCH: To evaluate the impact of ovulation-triggering agents on suboptimal mature oocyte yield in antagonist ICSI cycles. DESIGN: We conducted a retrospective cohort study of 2,129 antagonist ICSI cycles at a tertiary university hospital from October 2013 to October 2022. The primary outcome was suboptimal response to triggering, defined as a mature oocyte yield below the 75th percentile. Mature oocyte yield was calculated as the number of mature oocytes retrieved divided by the number of mature follicles (mean diameter ≥ 15 mm) on the trigger day. Prognostic factors for suboptimal response were analyzed using univariate and multivariate methods. RESULTS: Of the cycles, 909 (42.7%) were triggered with GnRHa, 845 (39.7%) with hCG, and 375 (17.6%) with both. The mean mature follicle count was 7.9 ± 4.3, the average number of mature oocytes was 7.0 ± 5.0, and the mean mature oocyte yield was 92.3 ± 55.2%. The 75th percentile for mature oocyte yield was 117%. Mature oocyte yield was significantly higher with GnRHa versus hCG (96.7 ± 59.1% vs. 87.6 ± 48.8%), with no significant difference compared to dual trigger (92.2 ± 58.0%; p = 0.017). Suboptimal yield was lower with GnRHa (71.6%) than hCG (80%), but not dual trigger (76.8%), p = 0.017. Multivariate analysis showed GnRHa triggering was associated with lower risk of suboptimal yield (p < 0.001). CONCLUSION: GnRHa triggering is associated with a reduced risk of suboptimal mature oocyte yield compared to hCG