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Background: -Dual triggering‖ for final oocyte maturation using acombination of a gonadotropin-releasing hormone agonist (GnRHa) and human chorionic gonadotropin (hCG) can improve clinical outcomes in high responders during in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) GnRH-antagonist cycles. Aim of the work:To compare gonadotrophin releasing hormone agonist with low dose human chorionic gonadotrophin co-triggers versus gonadotrophin releasing hormone agonist alone for reducing the threat of severe ovarian hyperstimulation in women suffering polycystic ovarian disease correlated with outcomes. Patients and methods: There were 120 infertile women who joined the ART department at the International Islamic Center for Population Studies and Research (IICPSR) Al-Azhar University hospitals who took part in this randomised control study. Results:The difference in the number of oocytes in M1 between the groups was statistically important (p= 0.0147). As well, there was statistically significant difference between the two groups regarding number of oocytes in M2 (p= 0.0140). Conclusion:The use of Gonadotrophin releasing hormone agonist with low dose human chorionic gonadotrophin co-triggers was not significantly prevent the risk of mild and moderate form ovarian hyperstimulation in women suffering from polycystic ovarian disease in comparison with gonadotrophin releasing hormone agonist alone with better outcomes for dual triggering, Also, both protocols were not record any cases of severe form.

Background: Pre-eclampsia is a heterogeneous disease influencing various systems of the body and commonly accompanied by morbidity and death. Early pre-eclampsia prognostication would decrease this accompanied morbidity and death as it will give the chance for common motherly and fetal surveillance and utilization of prophylactic operations. Objective: To assess whether the use of maternal platelet indices combined with uterine artery Doppler during 1st trimester could enhance the prediction of later pre-eclampsia in primigravidae women. Patients and Methods: This prospective study includes 30 pregnant women selected from Obstetrics and Gynecology department, Al-Azhar university hospitals. All the selected pregnant women were primigravidae in 1st trimester at the start of the study. The study was conducted from October 2020 to May 2021. Results: The uterine artery Doppler indices in prognostication of Preeclampsia were: sensitivity 85.7 %, specificity 91.3%, NPV 95.5%, and PPV 75% with an accuracy of 90%. The maternal platelets indices in prediction of Pre-eclampsia were: sensitivity 57.14%, specificity 91.3%, NPV 87.5%, and PPV 66.67% with an accuracy of 83.3%. The combined uterine artery Doppler and maternal platelets indices in prognostication of Pre-eclampsia were: sensitivity 85.7%, specificity 100%, NPV 95.8%, and PPV 100% with an accuracy of 96.7%. Conclusion:In our study, we figured out that the maternal platelets indices in combination with the Doppler assessment of the uterine artery as reliable screening tests to enhance the prognostication of Preeclampsia in primigravidae at the 1st trimester.