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Premature luteinization in controlled ovarian hyperstimulation has no adverse effect on oocyte and embryo quality
G E Hofmann1, F Bentzien, P A Bergh
1Department of Obstetrics and Gynecology, Mount Sinai Medical Center, New York, New York.
Objective:
To determine if premature luteinization has an adverse effect on oocyte and, hence, embryo quality.
Design:
Retrospective evaluation of anonymous ovum donors/oocyte recipients.
Setting:
A large oocyte donation program.
Patients, Participants:
Sixty-eight women undergoing controlled ovarian hyperstimulation (COH) as ovum donors were matched to 68 women with ovarian failure as ovum recipients who had endometrial maturation exogenously controlled by an identical hormone replacement protocol.
Interventions:
Serum was collected for E2 and P in donors and recipients.
Main Outcome Measures:
The incidence of premature luteinization was determined in donors. Cycle characteristics were compared between donors with and without premature luteinization, with emphasis on oocyte and embryo quality. Implantation rates per embryo and delivery rates per transfer were measured in recipients.
Results:
Twenty-one (31%) of the donors demonstrated premature luteinization. Serum P was higher on day before hCG, day of hCG, and day after hCG in women demonstrating premature luteinization. However, there were no differences between donor cycles with or without premature luteinization as determined by donor age, ampules of gonadotropins used, day of hCG administration, peak E2, total number of oocytes, and number of mature oocytes retrieved. Ovum recipients were of similar age and had similar E2 exposure (area under the E2 curve) before P administration. Similar fertilization rates, incidence of polyspermia, number of embryos transferred of similar embryo grade, and similar implantation rates and deliveries per transfer were observed in women receiving oocytes from donors with and without premature luteinization, respectively.
Conclusions:
Similar oocyte quality, fertilization, and polyspermia rates, embryo quality, implantation, and delivery rates suggest that any negative impact of premature luteinization on pregnancy rates in COH cycles from young women is not due to an adverse effect of PL on oocyte and hence embryo quality, but rather on the endometrial environment.