Does systemic LH concentration influence live birth rate in programmed single euploid frozen embryo transfer cycles?

Does systemic LH concentration influence live birth rate (LBR) in programmed single euploid frozen embryo transfer (seFET) cycles?

Retrospective cohort study including 758 programmed seFET cycles between January 2018 and September 2023, prepared with oral oestradiol and vaginal progesterone. Serum oestradiol, progesterone and LH were measured at the start of preparation and up to 3 days before initiation of vaginal progesterone. Patients were stratified in percentile groups according to LH concentration before oestradiol and vaginal progesterone administration. The impacts of LH concentration and its slope on LBR were assessed.

Pregnancy rate, pregnancy loss rate and LBR were 66.7%, 18.0% and 48.7%, respectively. Outcome groups were comparable in terms of female age at retrieval and transfer, anti-Müllerian hormone, male age, luteal phase support, and hormone concentrations before initiation of oestradiol and vaginal progesterone. No significant differences in LBR were seen between LH percentile groups. No significant trend was seen when categorizing the increase in LH concentration as small, moderate or substantial. Multi-nomial regression analysis showed that poorer embryo quality (inner cell mass grade C versus A; P = 0.005), biopsy on day 6/7 versus day 5 (P = 0.01), and higher body mass index (P = 0.031) were more likely to result in a negative pregnancy test than a live birth. Neither oestradiol nor LH concentrations prior to vaginal progesterone administration, nor their increase, were significantly associated with outcomes.

Systemic LH concentration before vaginal progesterone administration does not influence LBR in programmed seFET cycles.