[A new criterion for hCG administration in human IVF programs: importance of serum LH levels]

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)

Context:

• Optimizing ovulation induction is crucial for IVF success.
• Current protocols often rely on follicle size and estradiol levels, which can be variable.
• A more precise method for timing human chorionic gonadotropin (hCG) administration is needed.

Purpose:

• To introduce and evaluate a novel, simple criterion for timing hCG administration in IVF based on serum luteinizing hormone (LH) levels.
• To determine the efficacy of this LH-based criterion in achieving pregnancy.

Summary:

• A new criterion for hCG administration in IVF was developed, utilizing daily serum LH measurements.
• hCG was administered the night of the first day the LH level exceeded a calculated 'J level', irrespective of follicle size or estradiol.
• This method resulted in total and ongoing pregnancy rates of 35% and 27% per cycle, respectively.
• Deviations of one day in hCG administration decreased pregnancy rates.
• Successful pregnancies occurred across a broad range of dominant follicle diameters (14-21 mm) and estradiol levels (229-2,050 pg/ml).

Impact:

• Serum LH level monitoring provides a reliable parameter for timing hCG administration in IVF.
• This criterion may improve pregnancy outcomes by optimizing the timing of ovulation induction.
• The simplicity of the criterion allows for straightforward clinical application.