Exogenous luteinizing hormone (LH) increases estradiol response patterns in poor responders with low serum LH concentrations

Purpose: Our purpose was to investigate whether the addition of exogenous l euteinizing hormone (LN) increases estradiol secretion in LH-depleted women undergoing controlled ovarian hyperstimulation (COH) with purified follicl e stimulating hormone (FSN). Methods: We carried out case series and retrospective analysis of midfollic ular serum LH concentrations and estradiol response patterns in COH cycles. All patients initially received gonadotropins containing purified FSH Huma n menopausal gonadotropin containing LN was added to poor responders with l ow midfollicular LH concentrations. Results: The addition of exogenous LN to the CON regimen significantly incr eased estradiol secretion in poor responders with low midfollicular endogen ous LH concentrations. This was confirmed statistically by an average chang e in the slope of the estradiol patterns from 27.54 to 85.49 after the addi tion of exogenous LN. Furthermore, patients with midfollicular serum LH con centrations <3.0 mlU/ml had significantly lower midfollicular and peak estr adiol (E-2) concentrations compared to patients with LH concentrations grea ter than or equal to 3.0 mlU/ml (352.3 and 2094.3 vs 855.6 and 3757.1 pg/ m l, respectively). Conclusions: The addition of exogenous LH increases E-2 response patterns i n poor responders with low midfollicular serum LH concentrations. Low midfo llicular serum LH concentrations are associated with significantly lower mi dfollicular and peak E-2 concentrations.