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A dual-trigger approach was employed, consisting of combined recombinant hCG (Ovidrel 250 g, Merck Serono S.p.A., Modugno, Italy) and a GnRH agonist (Lupro 2 mg, Nang Kuang Pharmaceutical Co., Ltd., Tainan, Taiwan), when at least one follicle reached a mean diameter of 18 mm