Effects of low day 3 luteinizing hormone levels on in vitro fertilization treatment outcome

In a previous study we demonstrated that women with day 3 luteinizing hormo ne (LH) values <3 IU/1 subjected to controlled ovarian hyperstimulation wit hout pituitary desensitization responded with a lower number of follicles > 15 mm compared to women with a higher basal LH level. The aim of this stud y was to determine whether in patients with day 3 LH levels < 3 IU/l a furt her reduction of serum LH concentration by gonadotropin-releasing hormone ( GnRH) analog impairs follicular response to follicle stimulating hormone (F SH) and treatment outcome in in vitro fertilization (IVF) cycles. For this purpose we retrospectively studied 249 consecutive women subjected to standard IVF treatment employing pituitary desensitization with buserel in and follicular stimulation with urinary highly purified FSH. The patient s were divided into two groups according to their day 3 LH value. The first group (group A) showed day 3 LH levels < 3 IU/l and the second (group B) h ad day 3 LH levels > 3 IU/l. Group A and B patients did not show statistica lly significant differences in the ovarian response to FSH, nor in IVF trea tment outcome, showing that in FSH treated GnRH analog suppressed cycles, t he ovarian responsiveness and IVF outcome do not differ accorrding to basal LH values. However, the high dosage of FSH we employed in group A and B pa tients could account, at least in part,for this result. Indeed, comparative evaluations with unsuppressed cycles tour previous study) strongly suggest that a reduced ovarian responsiveness to gonadotropins in patients with da y 3 LH values < 3 IU/l should be considered in clinical practice.