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.
Esposito
M A
MA
Center for Reproductive Medicine and Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, USA.
Barnhart
K T
KT
Coutifaris
C
C
Patrizio
P
P
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