Ovarian response and pregnancy outcome related to midfollicular LH levels in down-regulated women undergoing assisted reproduction.
OBJECTIVE
To assess ovarian response and pregnancy outcome related to midfollicular luteinizing hormone (LH) levels in normogonadotropic women down-regulated with gonadotropin-releasing hormone-agonist (GnRH-a) (daily and depot) during an assisted reproduction cycle.


METHODS
In a prospective randomized trial, 50 women were down-regulated with leuprorelin, 0.5 mg/d subcutaneously (group A) and 50 with leuprorelin, 3.75 mg depot (group B), prior to ovarian stimulation with recombinant follicle-stimulating hormone (FSH). Midfollicular serum LH levels < or = 0.5 mIU/mL (subgroups A1 and B1) versus > 0.5 mIU/mL (subgroups A2 and B2) were considered. A comparative analysis was carried out on the clinical effects (duration of stimulation, total FSH dose, number of oocytes retrieved and pregnancy rate).


RESULTS
Maximum estradiol levels and pregnancy rates were higher in subgroups A2 and B2, with LH > 0.5 mIU/mL. No differences were observed in the cumulative amount of gonadotropin used, number of oocytes retrieved or fertilization rate.


CONCLUSIONS
When FSH only is used for ovarian stimulation, very low LH serum concentrations in normogonadotropic women profoundly suppressed with GnRH-a, especially if given as a depot, may adversely affect in vitro fertilization outcome.
Ferrari
Bruno
B
Department of Obstetrics and Gynecology, University of Parma, Parma, Italy. brunoferrari@unipr.it
Barusi
Lorenzo
L
Lanna
Mariano
M
Coppola
Francesco
F
D020341:Absorbable Implants; D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000494:pharmacology; D006801:Humans; D007279:Injections, Subcutaneous; D016729:Leuprolide / Q000008:administration & dosage / Q000494:pharmacology*; D007986:Luteinizing Hormone / Q000097:blood*; D010053:Ovary / Q000502:physiology*; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide