Elevated luteinizing hormone on the day of human chorionic gonadotropin administration does not reduce cycle fecundity in a low-dose flare-up in vitro fertilization protocol.
OBJECTIVE
To determine if elevated LH at the time of hCG administration occurs and adversely affects success in a low-dose gonadotropin-releasing hormone analogue (GnRH-a) flare-up protocol in hMG-stimulated IVF cycles.


METHODS
Pearson correlation matrix analysis of hormonal, gamete, and clinical data derived from 203 consecutive IVF cycles was performed. All patients were treated with low-dose GnRH-a (250 micrograms SC leuprolide acetate) and hMG. In 203 consecutive IVF cases, serum was obtained on the day of hCG administration and assayed for E2, LH, and P. These data were correlated with peak E2, number of follicles, oocytes, embryos, and conceptions. Additionally, patients with elevated LH were compared with the nonelevated LH group.


RESULTS
Twenty six women had LH > 35 mIU/mL (mean +/- SEM; 51.1 +/- 1.9) and five pregnancies (cycle fecundity 19.2% per retrieval). One hundred seventy-seven patients had LH < 35 mIU/mL (16.3 +/- 0.5) and 25 pregnancies (cycle fecundity 14.1%). There were no differences in the mean P (1.0 +/- 0.1 ng/mL, conversion factor to SI unit, 3.81) and E2 (1,672 +/- 144 pg/mL, conversion factor to SI unit, 3.671) of the former group compared with the P (1.1 +/- 0.07 ng/mL) and E2 (1,456 +/- 69 pg/mL) of the latter group. There was no correlation with the number of follicles, oocytes, embryos, pregnancies, E2, or P to LH concentration (rmax = 0.132).


CONCLUSIONS
In a low-dose, GnRH-suppression, IVF induction protocol, elevated LH occurs in a small subset (13%) of women at the time of hCG administration. This event does not appear to alter cycle fecundity nor induce premature luteinization.
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216.
S R
SR
Lincoln
C A
CA
Long
N S
NS
Whitworth
V M
VM
Sopelak
B D
BD
Cowan
D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D007986:Luteinizing Hormone / Q000097:blood*; D008596:Menotropins / Q000627:therapeutic use; D009865:Oocytes / Q000502:physiology; D011247:Pregnancy; D011374:Progesterone / Q000097:blood
D006063:Chorionic Gonadotropin; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone; D016729:Leuprolide