Background and aim: Dual triggering, which combines a gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (HCG), has been suggested to enhance outcomes in poor ovarian responders undergoing infertility treatment. This study aimed to compare the efficacy of dual trigger versus HCG trigger in improving assisted reproductive technology (ART) outcomes in poor responders using a protocol of GnRH antagonist.  
Methods: A prospective clinical randomized trial was conducted at Cairo University from June 2020 to March 2021, involving 86 poor responders. The study dual group (n=43) obtained a dual trigger of 5000 units of HCG plus triptorelin 0.2 mg and, whereas the other group (n=43) was given a conventional HCG trigger. Primary outcomes included the number of retrieved oocytes, mature oocytes (MII), obtained embryos, and fertilization rate.  
Results: The study group exhibited significantly higher numbers of retrieved oocytes, MII oocytes, fertilization rate, obtained embryos, and embryos transferred compared to the control group (P value < 0.05). Although the implantation rate and chemical pregnancy rate were higher in the study group, the differences were not statistically significant (P value 0.482 and 0.492, respectively). 
Conclusion:  dual triggering with HCG and GnRH agonist may enhance ovulation triggering and reproductive outcomes in poor responders undergoing antagonist ICSI cycles, leading to increased numbers of retrieved oocytes, MII oocytes, obtained embryos, and fertilization rate. However, the impact on pregnancy and implantation rates was not statistically significant.