Effects of recombinant LH (rLH) supplementation during controlled ovarian hyperstimulation (COH) in normogonadotrophic women with an initial inadequate response to recombinant FSH (rFSH) after pituitary downregulation

Placido, Giuseppe De; Alviggi, Carlo; Mollo, Antonio; Strina, Ida; Ranieri, A.; Alviggi, Erminia; Wilding, Martin; Varricchio, Maria Teresa; Borrelli, Antonio; Conforti, Salvatore

doi:10.1111/j.1365-2265.2004.02027.x

Cited by 75 publications

(45 citation statements)

References 34 publications

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“…Supplementation of LH activity in patients stimulated with constant FSH doses led to a shorter stimulation time and more rapid progress in follicular development and estradiol production (38). Several recent studies have investigated the usefulness of additional stimulatory LH activity in the form of menotropins, hCG or recombinant LH with conflicting results (37,(39)(40)(41). An agerelated decrease in metaphase II oocytes in patients receiving recombinant FSH alone, but not in patients additionally supplemented with recombinant LH, suggests a beneficial effect of LH supplementation in older patients (42).…”

Section: Discussionmentioning

confidence: 97%

Differences in serum LH and FSH levels using depot or daily GnRH agonists in controlled ovarian stimulation: influence on ovarian response and outcome of ART

Sonntag¹,

Kiesel²,

Nieschlag³

et al. 2005

J Assist Reprod Genet

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Section: Discussionmentioning

confidence: 97%

Differences in serum LH and FSH levels using depot or daily GnRH agonists in controlled ovarian stimulation: influence on ovarian response and outcome of ART

Sonntag¹,

Kiesel²,

Nieschlag³

et al. 2005

J Assist Reprod Genet

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“…However, the variable total amount of r-FSH had a significant heterogeneity (Cohran Q: 9.79, df:3 p = 0.02). De Placido et al [21] observed that the administration of a daily r-LH resulted in a significant decrease in that cumulative r-FSH amount and in a trend toward a reduction of the stimulation length. Balasch et al [22] reported that with a fixed regimen of 150IU r-FSH or HMG during the first 14 days of treatment, the duration of ovarian stimulation and the per cycle gonadotrophin amount dose were lower in group HMG.…”

Section: Discussionmentioning

confidence: 99%

Recombinant luteinizing hormone supplementation to recombinant follicle-stimulation hormone during induced ovarian stimulation in the GnRH-agonist protocol: A meta-analysis

Oliveira

Mauri

Petersen

et al. 2006

J Assist Reprod Genet

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Purpose: to compare the efficacy of recombinant LH supplementation for controlled ovarian stimulation in recombinant FSH and GnRH-agonist protocol.Methods: Search strategies included on-line surveys of databases. The fixed effects model was used for odds ratio and effect size (weighted mean difference). Four trials fulfilled the inclusion criteria.Results: a fewer days of stimulation (p < 0.0001), a fewer total amount of r-FSH administered (p < 0.0001) and a higher serum estradiol levels on the day of hCG administration (p < 0.0001) were observed for the r-LH supplementation protocol. However, differences were not observed in number of oocyte retrieved, number of mature oocytes, clinical pregnancy per oocyte retrieval, implantation and miscarriage rates. Conclusions: more randomized controlled trials are necessary before evidence-based recommendations regarding exogenous LH supplementation in ovarian stimulation protocols with FSH and GnRH-agonist for assisted reproduction treatment can be provided.

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“…Early studies identified a subgroup of normogonadotrophic patients who have normal estimated ovarian reserves but suboptimal responses to FSH stimulation (De Placido et al ., 2001, 2004, 2005; Mochtar et al ., 2007). Such women express ovarian resistance to FSH but seem to be distinct from classical poor responders because some investigators suggest that luteinizing hormone (LH) supplementation improves their ART treatment outcomes (Alviggi et al ., 2006).…”

Section: Individualized Ovarian Stimulationmentioning

confidence: 99%

Approaches to improve the diagnosis and management of infertility

Devroey¹,

Fauser

Diedrich

2009

Human Reproduction Update

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BACKGROUNDRecent advances in our understanding of the causes of infertility and of assisted reproductive technology (ART) have led to the development of complex diagnostic tools, prognostic models and treatment options. The Third Evian Annual Reproduction (EVAR) Workshop Meeting was held on 26–27 April 2008 to evaluate evidence supporting current approaches to the diagnosis and management of infertility and to identify areas for future research efforts.METHODSSpecialist reproductive medicine clinicians and scientists delivered presentations based on published literature and ongoing research on patient work-up, ovarian stimulation and embryo quality assessment during ART. This report is based on the expert presentations and subsequent group discussions and was supplemented with publications from literature searches and the authors' knowledge.RESULTSIt was agreed that single embryo transfer (SET) should be used with increasing frequency in cycles of ART. Continued improvements in cryopreservation techniques, which improve pregnancy rates using supernumerary frozen embryos, are expected to augment the global uptake of SET. Adaptation and personalization of fertility therapy may help to optimize efficacy and safety outcomes for individual patients. Prognostic modelling and personalized management strategies based on individual patient characteristics may prove to represent real progress towards improved treatment. However, at present, there is limited good-quality evidence to support the use of these individualized approaches.CONCLUSIONSGreater quality control and standardization of clinical and laboratory evaluations are required to optimize ART practices and improve individual patient outcomes. Well-designed, good-quality studies are required to drive improvements to the diagnosis and management of ART processes.

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Effects of recombinant LH (rLH) supplementation during controlled ovarian hyperstimulation (COH) in normogonadotrophic women with an initial inadequate response to recombinant FSH (rFSH) after pituitary downregulation

Abstract: These results suggest that patients with initial inadequate responses to rFSH after pituitary downregulation benefit from the addition of a daily dose of 150 IU of rLH, starting from the eighth day of stimulation.

Cited by 75 publications

References 34 publications

Differences in serum LH and FSH levels using depot or daily GnRH agonists in controlled ovarian stimulation: influence on ovarian response and outcome of ART

Differences in serum LH and FSH levels using depot or daily GnRH agonists in controlled ovarian stimulation: influence on ovarian response and outcome of ART

Recombinant luteinizing hormone supplementation to recombinant follicle-stimulation hormone during induced ovarian stimulation in the GnRH-agonist protocol: A meta-analysis

Approaches to improve the diagnosis and management of infertility

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