Bedeutung spezifischer LH-Muster vor und nach Ovulationsinduktion mit hCG im Rahmen der In-vitro-Fertilisierung und deren vereinfachte Diagnostik

Abstract

In 55 patients follicular stimulation for in vitro fertilisation (IVF) was carried out with a combination of clomiphene (Cl)/human follicle stimulating hormone (FSH) and human chorion gonadotropin (hCG) for ovulation induction. Two days before the anticipated hCG application LH measurements in 4-hourly urine samples were started and continued until follicular aspiration. A LH-IRMA (LH-MAIAclone, Serono) utilising monoclonal antibodies enabled the detection of LH also after hCG. In order to facilitate the organisation and to exclude sources of error the LH concentrations were correlated to the urinary creatinine concentrations and expressed as LH units per gram creatinine (LH U/g Cr). 6 characteristic LH profiles could be found: 31 patients (group a) had a baseline between 5-12 LH U/g Cr with an abrupt increase 10-12 hours after hCG, 2 patients (group b) had slightly elevated LH levels (10-15 LH U/g Cr), after hCG a decrease and 20-30 hours later a distinct increase. 7 patients (group c) had an endogenous LH surge before the hCG application. 3 patients (group d) had very low LH values (below 5 LH U/g Cr), 6 patients (group e) markedly increased concentrations (above 20 LH U/g Cr) with no change after hCG. 6 patients (group f) had significant LH fluctuations. Of the 15 pregnancies 12 were in group a, 2 in group b, 1 in group c, none in the groups d-f. The good correlation between the LH concentrations and creatinine concentrations in the urine proved the usefulness of this method and contributed well to organisational simplifications.(ABSTRACT TRUNCATED AT 250 WORDS)