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BOOK TITLE: Principles and Practice of Assisted Reproductive Technology
Ovulation trigger is defined as a bioactive preparation which will trigger a cascade of events resulting in the maturation and release of developmentally competent oocyte from a preovulatory graafian follicle. In an ovulatory cycle, luteinizing hormone (LH) surge is caused by estrogen released from preovulatory follicles, which leads to a cascade of reactions. After 36 hours of administration of ovulation trigger, a mature oocyte is released which allows correct timing of intercourse and intrauterine insemination (IUI). Dual trigger enables clinicians to lengthen time between ovulation triggering and oocyte pick up and also simultaneously adding a FSH component causing a FSH surge which can help overcome any impairment in granulosa cell function, oocyte meiotic maturation or cumulus expansion. Kisspeptins are recently discovered peptides which act on kisspeptide neurons located in the anteroventral periventricular nucleus, perventricular nucleus, anterodorsal preoptic nucleus, and pre arcuate nucleus in hypothalamus and are thought to play an important role of GnRH pulse generator in mammals. Advantages and disadvantages of each ovulation triggers are also tabulated in this chapter.