Effect of Dual Trigger with Follicle Stimulating Hormone and Chorionic Gonadotropin Hormone on Ovulation Rate in Infertile Women received Aromatase Inhibitor Superovulation in Kirkuk City, Iraq

Abstract

A prospective during the period October 2020 to April 2021, a comparative study was conducted at the Al-Nahrain University’s High Institute for Infertility Diagnosis and Assisted Reproductive Technologies (HIIDART). The study’s primary goal was to determine whether using a dual trigger (FSH and hCG) could increase the likelihood of achieving pregnancy. The participants in this study totaled one hundred women. Before taking part in the study, each participant signed a written informed consent form that was approved by the Al-Nahrain University’s Ethics Committee before participating. A total of one hundred and one women participated in the study, who were chosen from among those who attended the consultant clinic of the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies in New York City. On the day of the IUI An ultrasound scan of the vaginal cavity was performed after 36 to 48 hours of trigger ovulation to confirm ovulation, measure, and evaluate the endometrial pattern, and assess sub endometrial blood flow. FSH, LH, Progesterone, and E2 levels were determined in a blood sample drawn on the same day for hormonal testing. Luteal phase support was initiated on the day of the IUI and continued for two weeks by administering 400 mg of progesterone vaginal suppository daily to the patient. Estimation of Beta human chorionic gonadotropins 14 days after IUI. The distribution of study groups by general characteristics is shown in Table 1. Study patients’ age was ranging from 19 to 39 years with a mean of 29.98 years and a standard deviation (SD) of ± 5.3 years. The highest proportion of study patients in all groups was aged between 25–34 years, overweighed, and complained from infertility for less than five years’ duration. The comparison in hormonal parameters between study groups at day of IUI is shown in Table 4.5. Mean of FSH level was significantly lower (p = 0.031) in group C than that in groups A and B (6.98 versus 9.06 and 9.3 IU/L respectively). Mean of E2 level was significantly higher (p = 0.001) in-group A than that in groups B and C (69.62 versus 53.32 and 36.65 pg/mL, respectively). The comparison in percentage of change in hormonal parameters at day of IUI compared to that at day of trigger according pregnancy outcome is shown in table (4.16). No significant differences between women who get pregnant than that in those who didn’t, in percentage of change of all other hormonal parameters at day of IUI (p ≥ 0.05) compared to that at day of trigger.