IVF/ICSI outcome and serum LH concentration on day 1 of ovarian stimulation with recombinant FSH under pituitary suppression.
BACKGROUND
Down-regulation with GnRH agonist has been suggested to result in a profound suppression of LH bioactivity, reduced estradiol synthesis, and thus impaired IVF and pregnancy outcome. The aims of this study were: (i) to assess the usefulness of serum LH measurement on stimulation day 1 as a predictor of ovarian response, conception and pregnancy outcome in patients treated with long-term down-regulation with GnRH agonist and recombinant FSH, and (ii) to define the best threshold LH value, if any, to discriminate between women with different outcomes of IVF.


METHODS
Records of 2625 cycles in 1652 infertile women undergoing IVF (n = 1856) and/or ICSI (n = 769) treatment were reviewed.


RESULTS
The range of LH concentrations on stimulation day 1 overlapped among non-conception cycles, conception cycles, ongoing pregnancies and early pregnancy losses. Receiver operating characteristic (ROC) analysis showed that serum LH concentrations on stimulation day 1 were unable to discriminate between conception and non-conception cycles (AUC(ROC) = 0.51; 95% CI: 0.49-0.54) or ongoing pregnancies versus early pregnancy loss groups (AUC(ROC) = 0.52; 95% CI: 0.47-0.57). Stratification for various low serum levels of LH did not reveal significant differences with respect to conception or pregnancy outcome among different LH levels on stimulation day 1.


CONCLUSIONS
Serum LH concentration on stimulation day 1 cannot predict ovarian response, conception and pregnancy outcome in women receiving long-term down-regulation during assisted reproduction treatment.
Bjercke
S
S
Department of Obstetrics and Gynecology, National Hospital, University of Oslo, Norway. sverre.bjercke@rikshospitalet.no
Fedorcsak
P
P
Abyholm
T
T
Storeng
R
R
Ertzeid
G
G
Oldereid
N
N
Omland
A
A
Tanbo
T
T
D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000097:blood*; D010062:Ovulation Induction; D010902:Pituitary Gland / Q000187:drug effects; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic
D015415:Biomarkers; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone