The significance of high follicular-phase luteinizing hormone levels in the treatment of women with polycystic ovarian syndrome by in vitro fertilization

Tarlatzis, Basil C.; Grimbizis, Grigoris

doi:10.1007/bf02765740

Cited by 15 publications

(7 citation statements)

References 22 publications

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“…High LH levels have been associated with significant decreases in oocyte maturation and fertilization rates, and impaired embryo quality, consequently resulting in impaired pregnancy rates, and higher miscarriage rates ( Adams et al ., 1985 ; Stanger and Yovich, 1985 ; Hombur and Jacobs, 1989 ; Regan et al ., 1990 ; Sengoku et al ., 1997 ; Ludwig et al ., 1999 ; Jabara and Coutifaris, 2003 ; Urman et al ., 2004 ; van der Spuy and Dyer, 2004 ; Santos et al ., 2010 ). Hyperseceretion of LH during folliculogenesis may suppress FSH function, resulting in abnormal GC function by promoting premature GC luteinization and follicular aresia in small antral follicles from women with PCOS, causing premature oocyte maturation via inhibition of oocyte maturation inhibitors ( Tesarik, 2003 ; van der Spuy and Dyer, 2004 ; Dumesic et al ., 2007b ; Franks et al ., 2008 ), which all impair the quality of both oocyte and embryo ( Tarlatzis and Grimbizis, 1997 ; Dumesic et al ., 2002 ). LH may also activate premature meiotic processes by damaging the oocyte nucleus, leading to apoptosis via a receptor-coupled signal transduction system ( Yoshimura and Wallach, 1987 ; Kurzawa et al ., 2008 ).…”

Section: Extra-ovarian Factorsmentioning

confidence: 99%

“…Women with PCOS have elevated serum and FF AMH levels versus those of normal controls ( Pigny et al ., 2003 ; Laven et al ., 2004 ; Artini et al ., 2007 ), which is closely associated with increased development of antral follicles and follicular arrest in PCOS patients ( Artini et al ., 2007 ; Das et al ., 2008 ; Diamanti-Kandarakis, 2008 ; Franks et al ., 2008 ). Elevated AMH serum levels are directly correlated with increased testosterone and/or LH levels in women with PCOS, and profoundly impairing oocyte developmental competence and embryo quality ( Tarlatzis and Grimbizis, 1997 ; Dumesic et al ., 2002 , 2007b ; Patel and Carr, 2008 ; Franks et al ., 2008 ). Also, elevated FF AMH concentrations in women with PCOS are linked to an increased percentage of immature oocyte and lower fertilization rates when compared with women with endometriosis or pelvic adhesions ( Fallat et a., 1997 ); this is supported by evidence from the rat model as well ( Takahashi et al ., 1986 ).…”

Section: Intra-ovarian Factorsmentioning

confidence: 99%

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Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence

Qiao

Feng

2010

Human Reproduction Update

411

314

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BACKGROUNDPolycystic ovary syndrome (PCOS) is a common metabolic dysfunction and heterogeneous endocrine disorder in women of reproductive age. Although patients with PCOS are typically characterized by increased numbers of oocytes retrieved during IVF, they are often of poor quality, leading to lower fertilization, cleavage and implantation rates, and a higher miscarriage rate.METHODSFor this review, we searched the database MEDLINE (1950 to January 2010) and Google for all full texts and/or abstract articles published in English with content related to oocyte maturation and embryo developmental competence.RESULTSThe search showed that alteration of many factors may directly or indirectly impair the competence of maturating oocytes through endocrine and local paracrine/autocrine actions, resulting in a lower pregnancy rate in patients with PCOS. The extra-ovarian factors identified included gonadotrophins, hyperandrogenemia and hyperinsulinemia, although intra-ovarian factors included members of the epidermal, fibroblast, insulin-like and neurotrophin families of growth factors, as well as the cytokines.CONCLUSIONSAny abnormality in the extra- and/or intra-ovarian factors may negatively affect the granulosa cell–oocyte interaction, oocyte maturation and potential embryonic developmental competence, contributing to unsuccessful outcomes for patients with PCOS who are undergoing assisted reproduction.

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Section: Extra-ovarian Factorsmentioning

confidence: 99%

Section: Intra-ovarian Factorsmentioning

confidence: 99%

Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence

Qiao

Feng

2010

Human Reproduction Update

411

314

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“…PCOS, which is characterized by hyperandrogenism, chronic anovulation, hypersecretion of luteinizing hormone (LH) and insulin resistance, is itself associated with early pregnancy loss (7). Long-term pituitary desensitization with gonadotropin releasing hormone analog (GnRHa) may decrease miscarriage rate in PCOS patients (8), therefore, LH hypersecretion has been postulated as a cause of miscarriage in PCOS (9). PCOS patients, however, can be divided into two subgroups: lean, non-insulin resistant patients with high LH levels and obese, insulin resistant patients with normal LH secretion (10).…”

mentioning

confidence: 99%

Obesity is a risk factor for early pregnancy loss after IVF or ICSI

Fedorcsák¹,

Storeng²,

Dale³

et al. 2000

Acta Obstet Gynecol Scand

183

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“…15 Kolibianakis et al found that a significant decrease of both ongoing pregnancy rate and implantation rate was present across groups of patients with increasing LH levels. The highest implantation rate and ongoing pregnancy rate was present in those patients with LH levels on day 8 of stimulation ≤0.5IU/l.…”

mentioning

confidence: 99%

The effect of baseline serum luteinizing hormone levels on follicular development, ovulation, conception and pregnancy outcome in infertile patients with polycystic ovarian syndrome

Shanmugham

Vidhyalakshmi

Shivamurthy

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONPolycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder in infertile women. Infertility affects 40% of women with PCOS.1 Polycystic ovary syndrome (PCOS), a relatively common reproductive endocrine disorder often associated with high endogenous LH secretion, menstrual cycle disorders, infertility and high rates of spontaneous abortion, was considered the paradigm condition that proved the potential untoward actions of LH.Raised tonic levels of luteinizing hormone (LH) is one of the main endocrinological disturbances in PCOS patients.2 This inappropriate secretion of LH seems to affect both fertility and pregnancy outcomes of PCOS women. Increased production of androgens associated with high LH concentrations, coupled with their inefficient aromatization to estrogens related to the low FSH levels in PCOS patients, results in local androgen excess and oestrogen deficit within the ovary.3 This would constitute a potent androgenic environment for the follicle leading to cessation of follicular growth. This ABSTRACT Background: Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder in infertile women. Raised tonic levels of luteinizing hormone (LH) is one of the main endocrinological disturbances in PCOS patients. Objective of present study was to evaluate the effect of baseline serum luteinizing hormone levels on follicular development, ovulation and conception and pregnancy outcome in infertile patients with PCOS. Methods: This is a prospective study conducted on 50 consecutive infertile patients with PCOS. Baseline Day 2 serum luteinizing hormone concentration was done in selected patients. Ovulation induction was done with clomiphene citrate 100 mg from Day 3 to Day 7 of the cycle. Then patients were monitored for follicular development, ovulation, conception and early pregnancy loss. Results: The mean age of the patients is 25±3.6 yrs. The average duration of infertility is 5.4 yrs (2-10). The mean basal serum LH concentration in patients who ovulated was significantly low (5.6 IU) in comparison with patients who did not ovulate (10.1 IU). The mean basal serum LH concentration in patients who conceived was 3.9 IU in comparison with patients who did not conceive (5.9 IU) which was statistically significant (p=0.04). Out of 15 patients who conceived, 3 patients (20%) had early pregnancy loss. Conclusions: Tonic hyper secretion of LH results in premature oocyte maturation, causing the problems with fertilization and miscarriage. Inappropriately raised LH appears to have deleterious effects on the pregnancy outcome.

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The significance of high follicular-phase luteinizing hormone levels in the treatment of women with polycystic ovarian syndrome by in vitro fertilization

Cited by 15 publications

References 22 publications

Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence

Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence

Obesity is a risk factor for early pregnancy loss after IVF or ICSI

The effect of baseline serum luteinizing hormone levels on follicular development, ovulation, conception and pregnancy outcome in infertile patients with polycystic ovarian syndrome

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