INTRODUCTION
DIMINISHED OVARIAN RESERVE
Follicle development and dominant follicle selection are tightly regulated by
pituitary gonadotropins and intraovarian regulators (Traditionally, human chorionic gonadotropin (hCG) has been used as “faux” LH
surrogate to induce final oocyte maturation and meiosis. However, it is now well
understood that hCG and LH differ in the mechanism of inducing final oocyte
maturation at a molecular level (
This led to the development of the concept of a ‘dual trigger’, where a GnRH agonist
is used together with hCG as a trigger to achieve final oocyte maturation. Studies
conducted by different authors in patients with diminished ovarian reserve (DOR)
(