Esposito MA, Barnhart KT, Coutifaris C, Patrizio P. Role of periovulatory luteinizing hormone concentrations during assisted reproductive technology cycles stimulated exclusively with recombinant follicle-stimulating hormone.
Fertil Steril 2001;
75:519-24. [PMID:
11239535 DOI:
10.1016/s0015-0282(00)01745-3]
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Abstract
OBJECTIVE
To study the effect of endogenous luteinizing hormone (LH) concentration on fertilization, pregnancy, and early pregnancy loss rates.
DESIGN
Retrospective cohort study.
SETTING
Tertiary-care university center.
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 concentrations, 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 periovulatory LH value of 3 mIU/mL. After controlling for confounding variables with logistic regression, results showed that the fertilization rate was significantly lower in patients with a periovulatory LH <3 mIU/mL versus > or = 3 mIU/mL (52% and 58%, respectively; P=.03). Pregnancy rates and spontaneous abortion rates were similar in both groups. There 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 follicular phase of an IVF cycle are associated with significantly lower fertilization rates and a trend toward higher biochemical pregnancy rates. It may be of clinical benefit, when exclusively using r-hFSH in ART cycles, to add LH in the late follicular phase or to further reduce the dose of GnRH agonist.
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