Blunted LH surge after HCG administration in cycles superovulated for in-vitro fertilization.
The preovulatory pattern of serum luteinizing hormone (LH) was investigated in cycles superovulated for in-vitro fertilization (IVF). The method used was immunoradiometric assay which shows no cross-reactivity with human chorionic gonadotrophin (HCG) at concentrations usually found after HCG administration. Of the 245 cycles stimulated by clomiphene citrate + human menopausal gonadotrophin, an endogenous LH surge was observed in 29.8% of the patients shortly prior to the HCG injection. In the post-HCG period, 49.4% of the cycles exhibited a blunted LH rise, whereas in the remaining 20.8% the LH level did not exceed twice the mean preovulatory value. According to the oestradiol-17 beta (E2) and progesterone concentrations, different hormonal patterns were found in patients with pre-HCG and post-HCG elevation of LH. However, the occurrence of a blunted LH surge following HCG administration cannot be attributed to different, HCG-induced secretory patterns of progesterone. There were no significant differences in clinical parameters, the pregnancy rate was slightly but not significantly higher (19.0%) in the post-HCG LH surge group than in the two other groups (13.7%). It is presumed that various factors may contribute to the suspension of preovulatory LH suppression. The possible beneficial influence of a post-HCG surge of LH requires further investigation.
Hamori
M
M
In Vitro Fertilization Clinic, Würzburg, FRG.
Stuckensen
J A
JA
Rumpf
D
D
Kniewald
T
T
Kniewald
A
A
Marquez
M
M
D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D002996:Clomiphene / Q000627:therapeutic use; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D008596:Menotropins / Q000627:therapeutic use; D010060:Ovulation; D011374:Progesterone / Q000097:blood; D013480:Superovulation
D006063:Chorionic Gonadotropin; D002996:Clomiphene; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone