The impact of hCG trigger versus dual trigger on reproductive outcomes in elderly infertile women: a retrospective cohort study
Bibliographic record
Abstract
Purpose: This study was designed to evaluate the effects of dual trigger (GnRH agonist and hCG) compared with hCG trigger alone on oocyte quality, embryo development, and pregnancy outcomes in elderly women (aged≥35 years) who underwent IVF treatment with an antagonist stimulation protocol, aiming to identify the more optimal triggering strategy. Methods: This retrospective cohort study analyzed 449 elderly infertile women (≥35 years) who underwent antagonist stimulation protocols, including 236 patients in the hCG trigger group and 213 patients in the dual trigger group. The study compares the age, gravidity, parity, body mass index (BMI),anti-Müllerian hormone (AMH),gonadotropin (Gn) days, Gn dosage, trigger day luteinizing hormone (LH), trigger day estradiol (E2), trigger day progesterone (P), number of follicles ≥14mm on trigger day, number of oocytes retrieved, two pronuclei (2PN) fertilization rate, cleavage-stage embryo number, blastocyst number, embryo implantation rate (IR), clinical pregnancy rate (CPR), live birth rate (LBR), and miscarriage rate between the two groups. Multivariate logistic regression was used to analyze the influencing factors of CPR in patients. Results: There were no significant differences in baseline and cycle data between the two groups. In terms of oocyte and embryo outcomes, the number of oocytes retrieved (P=0.018), 2PN fertilization rate (P=0.046), and cleavage-stage embryo number (P=0.032) were significantly higher in the dual trigger group than in the hCG trigger group. There was no significant difference in the number of blastocysts obtained in the cycles of the two groups (P=0.689). In terms of pregnancy outcomes, the CPR per embryo transfer (ET) cycle (P=0.010),the CPR per frozen embryo transfer (FET) cycle (P=0.011), total embryo IR (P<0.001), total CPR (P<0.001), CPR per patient (P=0.003), total LBR (P<0.001), and LBR per patient (P=0.001) were all significantly higher in the dual trigger group than in the hCG trigger group. There was no significant difference in the miscarriage rate between the two groups (P=0.841). No cases of ovarian hyperstimulation syndrome (OHSS) occurred in either group. Conclusion: For elderly women undergoing antagonist stimulation protocols, the use of dual trigger, is more effective than hCG trigger alone in improving oocyte quality, embryo outcomes, and pregnancy outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".