Role of periovulatory luteinizing hormone concentrations during assisted reproductive technology cycles stimulated exclusively with recombinant follicle-stimulating hormone
Ma. Esposito et al., Role of periovulatory luteinizing hormone concentrations during assisted reproductive technology cycles stimulated exclusively with recombinant follicle-stimulating hormone, FERT STERIL, 75(3), 2001, pp. 519-524
Objective: To study the effect of endogenous luteinizing hormone (LH) conce
ntration on fertilization, pregnancy, and early pregnancy loss rates.
Design: Retrospective cohort study. Setting: Tertiary-care university cente
r.
Patient(s): One hundred sixty-six normogonadotropic patients undergoing IVF
.
Intervention(s): Luteal phase pituitary down-regulation and recombinant FSH
(Gonal-F) were used for ovarian stimulation. The mean of 4-5 serum LH conc
entrations, from stimulation days 5-12, was computed for analysis.
Main Outcome Measure(s): Fertilization, pregnancy, and early pregnancy loss
rates according to periovulatory levels of LH.
Result(s): Data were analyzed by stratifying patients according to a mean p
eriovulatory LH value of 3 mIU/mL. After controlling for confounding variab
les with logistic regression, results showed that the fertilization rate wa
s significantly lower in patients with a periovulatory LH <3 mIU/mL versus
<greater than or equal to>3 mIU/mL (52% and 58%, respectively; P=.03). Preg
nancy rates and spontaneous abortion rates were similar in both groups. The
re were seven biochemical pregnancies, all in patients with an LH <3 mIU/mL
(P=.07).
Conclusion(s): Low endogenous LH concentrations (<3 mIU/mL) in the late fol
licular phase of an IVF cycle are associated with significantly lower ferti
lization rates and a trend toward higher biochemical pregnancy rates. It ma
y be of clinical benefit, when exclusively using r-hFSH in ART cycles, to a
dd LH in the late follicular phase or to further reduce the dose of GnRH ag
onist. (C) 2001 by American Society for Reproductive Medicine.