Triggering oocyte maturation in in vitro fertilization treatment in healthy responders: a systematic review and network meta-analysis

作者：Yusuf Beebeejaun, Timothy P. Copeland, James M.N. Duffy, Ippokratis Sarris, Marian G. Showell, Rui Wang, Sesh Kamal Sunkara · 发表于：Fertility and Sterility · 年份：2024 · DOI：10.1016/j.fertnstert.2024.11.011 · 被引用次数：11 · 研究领域：Ovarian function and disorders、Reproductive Biology and Fertility、Gynecological conditions and treatments

To compare efficacy and safety of human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) agonist, dual, and double triggers in predicted healthy responders undergoing ovarian stimulation and in vitro fertilization. A systematic review and network meta-analysis of randomized controlled trials (RCTs). Randomized controlled trials indexed in PubMed, MEDLINE, EMBASE, clinical trial registries, and Cochrane Database of Systematic Reviews up to December 2023. Twelve high-integrity RCTs comprising 1,931 women were included, which compared hCG trigger with GnRH agonist trigger, dual trigger, and double trigger. Statistical analysis was performed using STATA version 16. Key outcomes included clinical pregnancy rates (CPR), live birth rates (LBR), number of oocytes, number of mature oocytes, miscarriage rates, and rates of ovarian hyperstimulation syndrome. The network meta-analysis for CPR were risk ratio (RR), 1.13; (95% confidence interval [CI], 0.80–1.60) for hCG vs. GnRH agonist trigger, RR, 1.23 (95% CI, 0.92–1.65) for hCG vs. dual trigger, RR, 0.38 (95% CI, 0.21–0.69) for hCG vs. double trigger, RR, 1.09 (95% CI, 0.70–1.70) for GnRH agonist vs. dual trigger and 0.34 (95% CI, 0.17–0.67) for GnRH agonist vs. double trigger, and RR, 0.31 (95% CI, 0.16–0.60) for double vs. dual trigger. Dual trigger demonstrated the highest Surface Under the Cumulative Ranking (85.1%), indicating superior efficacy for CPR. For LBR, although connectivity was limited, the RR was 1.3...