Recombinant human LH supplementation during GnRH antagonist administration in IVF/ICSI cycles: a prospective randomized study.
BACKGROUND
When administered in the late follicular phase to prevent an LH surge, GnRH antagonists induce a sharp decrease in serum LH levels that may be detrimental for assisted reproductive technology cycle outcome. Therefore, a prospective study was designed to assess the effects of recombinant human (r)LH supplementation during GnRH antagonist (cetrorelix) administration.


METHODS
The protocol consisted of cycle programming with oral contraceptive pill, ovarian stimulation with rFSH and flexible administration of a single dose of cetrorelix (3 mg). A total of 218 patients from three IVF centres were randomized (by sealed envelopes or according to woman's birth date) to receive (n = 114) or not (n = 104) a daily injection of rLH 75 IU from GnRH antagonist initiation to hCG injection.


RESULTS
The only significant difference was a higher serum peak E2 level in patients treated with rLH (1476 +/- 787 versus 1012 +/- 659 pg/ml, P < 0.001) whereas the numbers of oocytes and embryos as well as the delivery rate (25.2 versus 24%) and the implantation rate per embryo (19.1 versus 17.4%) were similar in both groups.


CONCLUSIONS
These results show that in an unselected group of patients, there is no evident benefit to supplement GnRH antagonist-treated cycles with rLH.
Cédrin-Durnerin
I
I
Centre for Reproductive Medicine, Jean Verdier Hospital, A.P.-H.P., 93143 Bondy--University Paris XIII, France. isabelle.cedrin-durnerin@jvr.ap-hop-paris.fr
Grange-Dujardin
D
D
Laffy
A
A
Parneix
I
I
Massin
N
N
Galey
J
J
Théron
L
L
Wolf
J P
JP
Conord
C
C
Clément
P
P
Jayot
S
S
Hugues
J N
JN
D000328:Adult; D002452:Cell Count; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D010064:Embryo Implantation / Q000187:drug effects; D004622:Embryo, Mammalian / Q000187:drug effects; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors* / Q000627:therapeutic use*; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D007986:Luteinizing Hormone / Q000627:therapeutic use*; D009865:Oocytes / Q000166:cytology / Q000187:drug effects; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome
D006727:Hormone Antagonists; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; C062876:cetrorelix