Recombinant LH (lutropin alfa) for the treatment of hypogonadotrophic women with profound LH deficiency: a randomized, double‐blind, placebo‐controlled, proof‐of‐efficacy study

Shoham, Zeev; Smith, Howard C.; Yeko, Timothy R.; O’Brien, Fanny; Hemsey, George; O’Dea, Louis

doi:10.1111/j.1365-2265.2008.03299.x

Cited by 57 publications

(57 citation statements)

References 62 publications

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“…Ovulation can be achieved either with pulsatile GnRH therapy [222][223][224] or, alternatively, with FSH treatment followed by hCG or LH to trigger ovulation. 225 One caveat is that most women with CHH do not secrete endogenous LH and, thus, require a complement of LH to stimulate local production of androgen substrates by theca cells, which facilitates sufficient secretion of estradiol by the dominant follicle. [226][227][228] Physiologic estradiol secretion promotes optimal endometrial development and the cervical mucus production needed for sperm transit and embryo implantation.…”

Section: Induction Of Female Sexual Characteristicsmentioning

confidence: 99%

“…229 Typically, subcutaneous FSH doses of 75-150 IU per day are sufficient. [223][224][225]229 The usual time required to obtain a dominant mature follicle (>18 mm) is ~12 days. [223][224][225]229 The starting dose of FSH is often increased or decreased depending on the ovarian response, as assessed by repeated serum estradiol measurements or by counting maturing follicles (using ultrasonography) performed approximately every 3-4 days.…”

Section: Induction Of Female Sexual Characteristicsmentioning

confidence: 99%

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European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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| Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), which is the master hormone regulating the reproductive axis. CHH is clinically and genetically heterogeneous, with >25 different causal genes identified to date. Clinically, the disorder is characterized by an absence of puberty and infertility. The association of CHH with a defective sense of smell (anosmia or hyposmia), which is found in ~50% of patients with CHH is termed Kallmann syndrome and results from incomplete embryonic migration of GnRHsynthesizing neurons. CHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. A timely diagnosis and treatment to induce puberty can be beneficial for sexual, bone and metabolic health, and might help minimize some of the psychological effects of CHH. In most cases, fertility can be induced using specialized treatment regimens and several predictors of outcome have been identified. Patients typically require lifelong treatment, yet ~10-20% of patients exhibit a spontaneous recovery of reproductive function. This Consensus Statement summarizes approaches for the diagnosis and treatment of CHH and discusses important unanswered questions in the field.

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Section: Induction Of Female Sexual Characteristicsmentioning

confidence: 99%

Section: Induction Of Female Sexual Characteristicsmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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“…The role of exogenous LH in hypogonadotrophic hypogonadism patients has been shown in many trials [11][12][13][14] whereas the efficacy of this stimulation protocol in other populations such as poor responders is somewhat undetermined. A recent study reported that a certain group of infertile women such as older women might benefit from LH supplementation [15].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of low dose hCG on oocyte maturity for ovarian stimulation in poor responder women undergoing intracytoplasmic sperm injection cycle: a randomized controlled trial

Madani

Yeganeh

Khodabakhshi

et al. 2012

J Assist Reprod Genet

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Purpose To investigate the effect of late follicular administration of low dose hCG on oocyte maturity in poor responding women undergoing intracytoplasmic sperm injection (ICSI). Materials and methods This prospective randomized pilot trial was performed on 73 poor responders undergoing ICSI, in Reproductive Biomedicine Research Center, Royan Institute, Tehran, Iran. All eligible patients underwent a GnRH-a long protocol and were randomly allocated into three study groups for ovarian stimulation: groupA received recombinant FSH alone, group B received recombinant FSH supplemented by 100 IU hCG. Group C received recombinant FSH supplemented by 200 IU hCG. The main endpoint was the number of metaphase II oocytes retrieved. Results Of 78 poor responding patients entered to this study, 73 women were considered eligible for enrolment. Of these, 26 women were allocated to receive only recombinant FSH, 24 patients allocated to receive recombinant FSH and 100 IU hCG and 23 patients were assigned to receive recombinant FSH and 200 IU hCG. Number of oocytes retrieved were significantly higher in group B compared to group A (6.5±3.3 versus 4.0±2.3; P0.03). Other cycle and clinical outcomes were comparable between three groups. Conclusions The present study demonstrated that adding 100 IU hCG to rFSH in a GnRH agonist cycle in poor responders improve response to stimulation whereas the number of metaphase II oocytes remains comparable between groups.

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“…However, the LH level in the GnRH antagonist protocol decreases (Duijkers et al, 1998;Griesinger et al, 2010) and this may negatively affect implantation or pregnancy rate (Esposito et al, 2001). LH secretion is necessary for appropriate follicular and endometrial development (Shoham et al, 2008;Kaufmann et al, 2007).…”

Section: Low Dose Hcg Administration In Conjunction With Gnrh Antagonmentioning

confidence: 99%

The Role of Low-Dose hCG in the Late Follicular Phase of Controlled Ovarian Hyper Stimulation (COH) Protocols

Ashrafi¹,

Kiani²

2012

In Vitro Fertilization - Innovative Clinical and Laboratory Aspects

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Recombinant LH (lutropin alfa) for the treatment of hypogonadotrophic women with profound LH deficiency: a randomized, double‐blind, placebo‐controlled, proof‐of‐efficacy study

Abstract: Subcutaneous co-administration of 75 IU lutropin alfa with follitropin alfa is safe and effective in inducing follicular development in women with profound gonadotrophin deficiency.

Cited by 57 publications

References 62 publications

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

Efficacy of low dose hCG on oocyte maturity for ovarian stimulation in poor responder women undergoing intracytoplasmic sperm injection cycle: a randomized controlled trial

The Role of Low-Dose hCG in the Late Follicular Phase of Controlled Ovarian Hyper Stimulation (COH) Protocols

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