Discontinuation of rLH two days before hCG may increase the number of oocytes retrieved in IVF

Abstract

BackgroundAdministration of recombinant luteinizing hormone (rLH) in controlled ovarian hyperstimulation may benefit a subpopulation of patients. However, late follicular phase administration of high doses of rLH may also reduce the size of the follicular cohort and promote monofollicular development.MethodsTo determine if rLH in late follicular development had a negative impact on follicular growth and oocyte yield, IVF patients in our practice who received rFSH and rLH for the entire stimulation were retrospectively compared with those that had the rLH discontinued at least two days prior to hCG trigger.ResultsThe two groups had similar baseline characteristics before stimulation with respect to age, FSH level and antral follicle count. However, the group which had the rLH discontinued at least two days prior to their hCG shot, had a significantly higher number of oocytes retrieved, including a higher number of MII oocytes and number of 2PN embryos.ConclusionsWhen using rLH for controlled ovarian hyperstimulation, administering it from the start of stimulation and stopping it in the late follicular phase, at least two days prior to hCG trigger, may increase oocyte and embryo yield.

A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation

“…Other published studies also aimed to assess the ovarian response by combining variables [9,11,20,22,39]. However, either these formulas were too complex compared to the simplicity of the ORPI [9,24] or a wide variety of variables were included, which made the assessment complex [11,20,22]. Other studies [51,52] described an index whose calculation required at least 1 cycle of treatment.…”

Expand evaluation of the ovarian response prediction index (ORPI) for individualised controlled ovarian stimulation

“…Other published studies also aimed to assess the ovarian response by combining variables (la Cour Freiesleben et al,2011, Lekamge et al,2007, Muttukrishna et al,2005, Younis et al,2010, Yovich et al,2012. However, either these formulas were too complex compared to the simplicity of the ORPI (Lekamge et al,2007, Spencer et al,2010] or a wide variety of variables were included, which made the assessment complex (Younis et al,2010, Yovich et al,2012. Other studies (Biasoni et al,2011, Gallot et al,2012 described an index whose calculation required at least 1 cycle of treatment.…”