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    <journal-meta>
      <journal-id journal-id-type="nlm-ta">J Reprod Infert</journal-id>
      <journal-id journal-id-type="publisher-id">arij001</journal-id>
      <journal-title-group>
        <journal-title>Journal of Reproduction &amp; Infertility</journal-title>
      </journal-title-group>
      <issn pub-type="ppub">2228-5482</issn>
      <issn pub-type="epub">2251-676X</issn>
      <publisher>
        <publisher-name>Avicenna Research Institute</publisher-name>
      </publisher>
    </journal-meta>

    <article-meta>
      <article-id pub-id-type="publisher-id">jri120139</article-id>
      <article-id pub-id-type="doi"></article-id>
      <article-id pub-id-type="pmid"></article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
             <subject></subject> 
        </subj-group>
        <subj-group>
            <subject></subject>
        </subj-group> 
      </article-categories>
      <title-group>
        <article-title>Dual Trigger with Gonadotropin Releasing Hormone Agonist and Human Chorionic Gonadotropin of Fresh Autologous Cycles in High Responders: A Systematic Review</article-title>
      </title-group>
        <contrib-group><contrib contrib-type="author"><name><surname>Vyrides</surname><given-names>Andreas A</given-names></name></contrib><aff>Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Mahdi</surname><given-names>Essam El</given-names></name></contrib><aff>Department of Obstetrics and Gynaecology, Newham University Hospital NHS Trust, London, United Kingdom</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Lamnisos</surname><given-names>Demetris</given-names></name></contrib><aff>Department of Health Sciences, School of Sciences, European University of Cyprus, Nicosia, Cyprus</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Giannakou</surname><given-names>Konstantinos</given-names></name></contrib><aff>Department of Health Sciences, School of Sciences, European University of Cyprus, Nicosia, Cyprus</aff></contrib-group>
      <pub-date pub-type="ppub">
        <day></day>
        <month></month>
        <year></year>
      </pub-date>
      <pub-date pub-type="epub">
        <day></day>
        <month></month>
        <year></year>
      </pub-date>
      <volume>23</volume>
      <issue>1</issue>
      <fpage>03</fpage>
      <lpage>18</lpage>
      <history>
        <date date-type="received">
          <day>8</day>
          <month>3</month>
          <year>2021</year>
        </date>
        <date date-type="accepted">
          <day>10</day>
          <month>8</month>
          <year>2021</year>
        </date>
      </history>
      <abstract>
      <p>
      &lt;p&gt;Background: The purpose of the current study was to investigate the effect of coadministration of human chorionic gonadotropin (hCG) with gonadotropin releasing hormone agonist (GnRH-a) trigger (dual trigger) in high responders for fresh autologous cycles in order to investigate the pregnancy outcomes and rates of ovarian hyperstimulation syndrome (OHSS) in comparison to GnRH-a trigger alone.&lt;br /&gt;
Methods: A systematic search was performed in PubMed and Ovid MEDLINE from inception through February 2020. The included materials were case-control, cohort and, cross-sectional studies as well as clinical trials in which the outcomes of dual trigger with GnRH-a were compared for final oocyte maturation in high responders undergoing GnRH-ant cycles.&lt;br /&gt;
Results: Five retrospective studies were included for this review. Three of the studies showed that the use of dual trigger versus GnRH-a trigger resulted in no statistically significant difference in rates of OHSS while achieving a statistically significant difference in favor of the dual trigger group in ongoing pregnancy rates, early pregnancy loss, and fertilization rates.&lt;br /&gt;
Conclusion: Currently, there is insufficient evidence to support improved clinical pregnancy rate, fertilization rate, live birth rate, and early pregnancy loss rate by the use of dual trigger versus GnRH-a trigger. Larger double-blind clinical studies are required to properly evaluate the efficacy of this protocol for use in high responders.&lt;/p&gt;

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      </abstract>
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