Recombinant luteinizing hormone supplementation to recombinant follicle-stimulating hormone induced ovarian hyperstimulation in the GnRH-antagonist multiple-dose protocol

Abstract

Except for higher E(2) and LH levels on the day of HCG administration, no positive trend in favour of additional LH was found as defined by treatment outcome parameters.

Follicular fluid hormonal profile and cumulus cell gene expression in controlled ovarian hyperstimulation with recombinant FSH: effects of recombinant LH administration

“…Although LH can substitute for FSH in supporting the later stages of follicular growth [55] and can stimulate optimal follicle-oocyte maturation [33], its role in controlled ovarian stimulation (COS) is still controversial [29,44].…”

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

“…Therefore follicles are deprived of their LH substances (Alviggi et al, 2006). A stimulation regimen consisting of GnRH-antagonist and exogenous LH in normal responders increases estradiol production but has no significant effect on improvement of IVF outcomes (Cedrin-Durnerin et al, 2004;Griesinger et al, 2005). However, this regimen is useful for women at risk for poor ovarian response (patients with less than four follicles in prior cycles and/or with basal FSH concentrations of more than 10 IU/L) (De placido et al, 2006).…”

The Use of rLH, HMG and hCG in Controlled Ovarian Stimulation for Assisted Reproductive Technologies

“…While direct measures of oocyte quality are difficult to assess clinically, some studies have noted an increased fertilization rate in oocytes obtained from cycles stimulated with LH (24,30). Numerous trials have also demonstrated that the addition of LH activity results in an increase in serum estradiol on the day of hCG (Figure 2), which may represent a higher quality cohort of developing follicles (22,26,30,(35)(36)(37)(38)(39)(40)(41)(42)(43). LH supplementation was demonstrated to result in lower levels of apoptosis in cumulous cells as compared to FSH stimulation only (44).…”

“…There are numerous RCT evaluating rLH plus rFSH versus rFSH alone, but the data is complicated by significant heterogeneity between the trials (29,30,(36)(37)(38)(39)(40)(41)(86)(87)(88)(89)(90)(91)(92)(93)(94)(95). The fact that the rLH dose can be administered at a separate starting time and doses from the rFSH dose has allowed researchers and clinicians to be more varied in the approach to rLH administration as compared to hMG.…”