The Effect of Trigger-to-Retrieval Time Interval on Assisted Reproductive Technology Outcomes in Patients with Poor Ovarian Response: The Effect of Trigger-to-Retrieval Time Interval on Assisted Reproductive Technology Outcomes

Fatemeh Sarvi; Masoome Jabarpour; Ashraf Aleyasin; Marzieh Aghahosseini; Sedigheh Hosseini Mousa; Ayda Najafian; Elham Madreseh; Parvin Sadat Eslamnike

Authors

Fatemeh Sarvi 1-Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran/ 2-Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Masoome Jabarpour Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Ashraf Aleyasin 1-Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran/ 2-Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Marzieh Aghahosseini 1-Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran /2-Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Sedigheh Hosseini Mousa 1-Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran/ 2-Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Ayda Najafian 1-Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran/ 2-Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Elham Madreseh 1-Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran/ 2-Clinical Research Development Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Parvin Sadat Eslamnike 1-Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran/ 2-Department of Obstetrics and Gynecology, Emam Sajad Hospital, Yasuj University of Medical Sciences, Iran

Keywords:

Dual Trigger; Oocyte Pickup (OPU); Poor Ovarian Response (POR); Assisted Reproductive Technology (ART)

Abstract

Background: The timing of oocyte retrieval after the oocyte maturation trigger is a critical factor influencing the clinical outcomes of assisted reproductive technologies (ART). This study examined how different time intervals of 34 and 36 hours between trigger administration and oocyte pickup (OPU) influence on ART outcomes in patients with poor ovarian response (POR). Materials and Methods: This prospective randomized controlled study enrolled 217 women undergoing intracytoplasmic sperm injection (ICSI) cycles between April 2024 and March 2025. All participants received a GnRH antagonist protocol, followed by a dual trigger for final oocyte maturation. The cycles were stratified into two groups based on the time interval between trigger administration and OPU at 34 and 36 hours. Comparative analyses were conducted to evaluate the outcomes between the two groups. Results: Throughout the trial, no significant statistical differences were observed between the intervention and control groups concerning baseline clinical and demographic characteristics, except for the antral follicle count (AFC) at baseline. The findings revealed that the 34-hour OPU group exhibited a significantly higher number of retrieved oocytes, oocyte maturity rate, fertilization rate, and number of high-quality embryos compared to the 36-hour group (P<0.05). Furthermore, pregnancy outcomes were most favorable in the 34-hour group (P<0.05). After adjusting for AFC, all observed differences remained statistically significant, with the exception of the fertilization rate. Conclusions: Our findings suggest that in POR patients, a 34-hour OPU interval with dual triggering significantly improves fertilization rates, embryo quality, biochemical and chemical pregnancy rates compared to 36 hours. This timing adjustment may enhance oocyte maturation and optimize ART success rates.

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The Effect of Trigger-to-Retrieval Time Interval on Assisted Reproductive Technology Outcomes in Patients with Poor Ovarian Response