Role of periovulatory luteinizing hormone concentrations during assisted reproductive technology cycles stimulated exclusively with recombinant follicle-stimulating hormone.
OBJECTIVE
To study the effect of endogenous luteinizing hormone (LH) concentration on fertilization, pregnancy, and early pregnancy loss rates.


METHODS
Retrospective cohort study.


METHODS
Tertiary-care university center.


METHODS
One hundred sixty-six normogonadotropic patients undergoing IVF.


METHODS
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.


METHODS
Fertilization, pregnancy, and early pregnancy loss rates according to periovulatory levels of LH.


RESULTS
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).


CONCLUSIONS
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.
Center for Reproductive Medicine and Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, USA.
M A
MA
Esposito
K T
KT
Barnhart
C
C
Coutifaris
P
P
Patrizio
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D015331:Cohort Studies; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000627:therapeutic use; D043373:Follicle Stimulating Hormone, Human; D005498:Follicular Phase; D006801:Humans; D016015:Logistic Models; D007986:Luteinizing Hormone / Q000097:blood*; D010060:Ovulation; D010062:Ovulation Induction; D011247:Pregnancy; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic
D006063:Chorionic Gonadotropin; D043373:Follicle Stimulating Hormone, Human; D011994:Recombinant Proteins; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone