LH supplementation in down-regulated women undergoing assisted reproduction with baseline low serum LH levels

Gynecol Endocrinol. 2010 Feb;26(2):118-24. doi: 10.3109/09513590903215516.

Abstract

Aim: The aim of our study is to evaluate the effect of recombinant-human LH supplementation on ovarian response and pregnancy outcome, during ovarian stimulation, in down-regulated women with baseline low serum LH levels undergoing assisted reproductive technology.

Study design: A prospective randomized study performed with 80 women, with serum LH levels 50.5 IU/l on cycle Day 6 of stimulation. Group-A (40): 14-days after down-regulation with leuprorelin, ovarian stimulation was initiated only with r-FSH 225 IU. Group-B (40): at the same time stimulation was initiated with rFSH 225 IU associated with rLH 75 UI on cycle Day 6 of stimulation.

Results: Serum-E2 levels on the hCG-day administration were significantly reduced in the Group-A. FF-VEGF levels were higher in Group-A. We did not find significant differences in the number of retrieved oocytes. The quality of oocytes proved to be higher and more significant from a statistical point of view in Group-B. The number of embryos obtained and transferred, the pregnancy rate lower in Group-A.

Conclusions: In our study, it was shown that LH supplementation seems to have a beneficial effect on the maturity and fertilizability of oocyte. Lower FF VEGF levels, found in Group B, could be an indication of a lower apoptosis rate in human cumulus cells after administration of LH. We can affirm that LH-supplementation is beneficial in patients who show asignificant serum LH suppression during the receptorial down-regulation

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Down-Regulation / drug effects
  • Embryo Transfer
  • Estradiol / blood
  • Female
  • Fertility Agents, Female / administration & dosage
  • Fertilization in Vitro
  • Follicular Fluid / metabolism
  • Humans
  • Leuprolide / administration & dosage
  • Luteinizing Hormone / administration & dosage*
  • Luteinizing Hormone / blood*
  • Ovulation Induction / methods*
  • Pregnancy
  • Prospective Studies
  • Recombinant Proteins / administration & dosage
  • Statistics, Nonparametric
  • Vascular Endothelial Growth Factor A / metabolism
  • Young Adult

Substances

  • Fertility Agents, Female
  • Recombinant Proteins
  • Vascular Endothelial Growth Factor A
  • Estradiol
  • Luteinizing Hormone
  • Leuprolide