Split daily recombinant human LH dose in hypogonadotrophic hypogonadism: a nonrandomized controlled pilot study

Area of Science:

• Reproductive Endocrinology
• Infertility Treatment
• Hormone Therapy

Background:

• Primary hypogonadotrophic hypogonadism (HH) is characterized by low gonadotropin levels, leading to anovulation, amenorrhea, and infertility.
• Current treatment protocols for HH often involve recombinant human follicle-stimulating hormone (rFSH) and recombinant human luteinizing hormone (rHLH).

Purpose of the Study:

• To investigate the efficacy of split daily doses of rHLH compared to a single daily dose in supporting follicular development and ovulation in women with HH.
• To evaluate the impact of rHLH dosing strategy on key ovulation end points.

Main Methods:

• A prospective, controlled, nonrandomized pilot study involving 27 women with HH.
• Participants received a fixed daily dose of rFSH supplemented with rHLH (75 IU daily).
• The rHLH was administered either as a single daily dose (n=9) or four equally divided doses (n=18).

Main Results:

• The split-dose group showed a higher proportion of women achieving all three ovulation end points (72.2% vs. 55.6%) compared to the single-dose group, though not statistically significant.
• Women in the split-dose group exhibited higher serum estradiol concentrations per follicle, improved endometrial thickness, and a greater number of follicles.
• The odds ratio for ovulation rate in the split-dose group was 2.08, indicating a trend towards increased ovulation, without statistically significant difference.

Conclusions:

• Administering rHLH in split daily doses may offer superior results in supporting follicular development and ovulation compared to the traditional single daily dose in women with HH.
• The split-dose regimen appears promising for improving ovulation rates and reproductive outcomes in this patient population.
• No serious adverse side effects were reported with either dosing regimen.