Effect of dual trigger with chorionic gonadotropin hormone and follicle-stimulating hormone on endometrial thickness in infertile women who had superovulation with an aromatase inhibitor
Authors: Mustafa Salwa Sadoon , Mousa Enas Thamer 
Published: April 2023

Beginning in October 2020 and ending in April 2021, researchers from Al-Nahrain University's High Institute for Infertility Diagnosis and Assisted Reproductive Technologies compared the success rates of two different methods of diagnosing and treating infertility. The major purpose of the research was to assess the impact of a combined trigger (follicle-stimulating hormone [FSH] and human chorionic gonadotropin [hCG]) on endometrial receptivity (endometrial thickness, endometrial pattern, sub-endometrial blood flow). A total of 100 females took part in the study. All patients gave their informed written consent, and the study was approved by the Al-Nahrain University Ethics Committee. Procedure Time To confirm ovulation, measure and analyze the endometrial pattern, and examine the sub-endometrial blood flow, a vaginal ultrasound was done 36 to 48 hours following trigger ovulation. All four hormones (FSH, LH, Progesterone, and E2) were tested in the blood at the same time to determine whether a couple was fertile, a complete medical history, and physical examination whereas performed on each member of the pair. An ultrasound vaginal probe was used to do the transvaginal examination. Patients were placed in the dorsal lithotomy position with an empty bladder for early follicular US (CD 2-3) to assess the number of antral follicles, measure endometrial thickness, and rule out ovarian cysts or other pathology. A second ultrasound was performed during the middle of the cycle (CD9-14) to determine whether a mature follicle had been found. A multiplanar image of the uterus was acquired after an ultrasound scan was swept across the mid-sagittal plane. Endometrial thickness in the median longitudinal plane of the uterus was calculated as the largest distance from one basal endometrial interface via the endometrial canal to the opposite endometrial-myometrial interface of the anterior-posterior uterine wall. A statistically significant difference was found between Group A's average E2 concentration of 69.62 pg/mL and Groups B and C's concentrations of 53.32 and 36.65 pg/mL. (P 0.001). In group C, there was a statistically significant difference in E2 levels on the day of the trigger and the day of the IUI (P = 0.036). On the day of IUI compared to the day of trigger, no statistically significant differences were seen between the study groups for any of the other hormonal indicators (P > 0.05). There were no significant differences (P > 0.05) in any of the baseline clinical measures between the research groups. All clinical indicators were comparable across groups (P > 0.05). There were no statistically significant differences (P > 0.05) between the research groups on any other clinical indicators. When comparing groups, A, B, and C on the decline in RI between the trigger and IUI days, group A significantly outperformed the others (P = 0.003). There was no statistically significant difference (P > 0.05) in any of the other clinical parameters between the IUI and trigger groups on the day of IUI.