Recombinant luteinizing hormone in ovarian hyperstimulation after stimulation failure in normogonadotropic women

The aim of this study was to examine the effect of an additional administra tion of recombinant luteinizing hormone (r-LH) to a gonadotropin-releasing hormone agonist (GnRHa) long protocol using recombinant follicle-stimulatin g hormone (r-FSH). In particular we determined whether such a stimulation p rotocol would be more effective in women (1) who respond poorly to stimulat ion with GnRHa long protocol using r-FSH only, and (2) whose LH concentrati ons after down-regulation in the cancelled cycle were low but above the val ues reported in the literature to be sufficient for folliculogenesis. After GnRHa desensitization 150 IU r-FSH and 75 IU r-LH were administered subcut aneously daily to six normogonadotropic women with low response to ovarian hyperstimulation using a GnRHa long protocol with r-FSH and low LH concentr ations after down-regulation in the cancelled cycle. All six women had an o ocyte retrieval and an embryo transfer after follicular stimulation. One wo men conceived but had a miscarriage in the eleventh week of gestation. Our results suggest that women with low response to a GnRHa long protocol with r-FSH, and whose LH concentration after down-regulation in the cancelled cy cles were low, benefit from the additional administration of r-LH in a GnRH a long protocol using r-FSH. It seems that dire to the additional administr ation of r-LH the LH concentration in the follicular phase is sufficient to support folliculogenesis.