Improved pregnancy rates with luteinizing hormone supplementation in patients undergoing ovarian stimulation for IVF

Abstract

Introduction Luteinizing hormone (LH) is believed to play a role in follicle maturation during the natural cycle. However, the need for co-treatment with recombinant LH (rLH) for controlled ovarian stimulation is controversial. Purpose The primary objective of our study was to determine if pregnancy rates are improved when rLH is used in addition to rFSH for ovarian stimulation. Secondary outcomes were fertilization rate, implantation rate and live birth rate. Methods A retrospective cohort study was performed of 1565 IVF or ICSI cycles. Outcomes were compared between ovarian stimulation cycles from 2007 when rLH and rFSH was used (n0765) to 2006 when rFSH only was used (n-800). Results Improved outcomes were found for rLH + rFSH versus rFSH alone for; pregnancy rate (61% and 54% respectively, p00.006), live birth rate (49% and 42% respectively, P 00.01), fertilization rate (74% versus 72% respectively, p00.04 and implantation rate (41% versus 37% respectively, p00.03).Conclusions Our large retrospective cohort study showed an improved pregnancy rate and live birth rate with rLH supplementation. This was associated with an improved fertilization and implantation rate and therefore may reflect an improvement in oocyte quality and/or uterine receptivity.

Identification of Early-Onset Preeclampsia-Related Genes and MicroRNAs by Bioinformatics Approaches

“…26 Little is known on the association between LHB and EOPET, but previous study suggests that LH plays an important role in placental implantation by increasing blood flow through vasodilatation or through angiogenesis and trophoblast. 27 However, high serum concentration of LH may negatively affect implantation. 28 This implies that the balance of LH is essential for placental implantation.…”

Cost-effectiveness of different types of COH protocols for in vitro fertilization at national level

“…There is evidence that adding LH during ovarian stimulation improves the IVF/ ICSI outcomes, especially in specific groups, e.g. patients with reduced ovarian reserve, low responders, patients with PCOS (polycystic ovarian syndrome), patients older than 35 years and those with reduced endogenous LH levels [23][24][25][26].…”

rLH/rFSH Combination Improved Cumulative Live Birth Rate in Patients With LH Over-Suppression Following GnRH Agonist Pituitary Down-Regulation Compared to rFSH or hMG Alone: A Retrospective Cohort Study With Propensity Score Matching

“…Sonntag et al report that long-term use of GnRH-a can lead to low levels of endogenous LH [19], thus it is important to supplement exogenous LH in patients with low LH levels [20]. Previous studies also found that patients with low serum LH levels achieved better clinical pregnancy rates after adding exogenous LH [15,[21][22][23][24]. Franco et al report that supplementation with rLH signi cantly increases the number of fertilized oocytes obtained and the rate of cumulative live births [25].…”