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Exogenous luteinizing hormone in controlled ovarian hyperstimulation for assisted reproduction techniques
Anna Pia Ferraretti1, Luca Gianaroli, Maria C Magli
1SISMER Reproductive Unit, Bologna, Italy. Annapia.Ferraretti@sismer.it
Objective:
To investigate the role of exogenous LH in controlled ovarian hyperstimulation for assisted reproductive technologies.
Design:
Prospective randomized study.
Setting:
SISMER fertility unit.
Patient(S):
Women showing a hyporesponsiveness to FSH under GnRH agonist down-regulation were randomized into three groups: group A (n = 54) received an increased dosage of FSH; group B (n = 54) was administered recombinant LH in addition to the increased dose of FSH; group C (n = 22) was given additional FSH and LH using hMG as a combined drug. Fifty-four age-matched women with no need to increase the FSH dose were included as a control group (D).
Intervention(S):
None.
Main Outcome Measure(S):
Implantation and live birth rate per started cycles.
Result(S):
In group B, the pregnancy and implantation rates were statistically higher when compared with groups A and C and did not differ from the control group for normal response. The live birth rate was similar in groups B and D but was half as high in groups A and C.
Conclusion(S):
Hyporesponsiveness to FSH could be related to iatrogenic LH deficiency that, in turn, could affect oocyte competence. Addition of a small amount of recombinant LH is able to rescue oocyte competence to produce viable embryos.