title: Evaluating the role of exogenous luteinizing hormone in poor responders undergoing in vitro fertilization with gonadotropin-releasing hormone antagonists.
abstract: OBJECTIVE
  To evaluate the importance of exogenous LH in poor responders undergoing IVF with GnRH antagonists.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  University-based IVF center.
  
  
  METHODS
  All patients with a history of poor response to ovarian stimulation undergoing IVF with GnRH antagonists between September 2000 and August 2001.
  
  
  METHODS
  None.
  
  
  METHODS
  Clinical pregnancy rates.
  
  
  RESULTS
  Two hundred forty GnRH-antagonist cycles were initiated in poor responders. One hundred fifty-three progressed to oocyte retrieval. Seventy-five patients received recombinant FSH (Rec) for ovarian stimulation, and 66 received hMG in combination with Rec. In patients aged <40 years, there were no significant differences in amount and duration of treatment, number of oocytes retrieved, and number of embryos between treatment groups. In patients aged > or =40 years, significantly fewer oocytes were retrieved in groups who received exogenous LH in their stimulation, resulting in significantly fewer fertilized embryos. Implantation and clinical pregnancy rates did not differ by treatment group.
  
  
  CONCLUSIONS
  In poor responders undergoing IVF with GnRH antagonists, outcomes are comparable whether stimulation is achieved in the presence or absence of supplemental LH. Exogenous LH does not appear to be necessary to achieve pregnancy in these challenging patients and may be detrimental to older patients with a history of poor response.
authors.affiliation: New York University Program for Infertility, Reproductive Surgery, and In Vitro Fertilization, New York, New York, USA. karinechung@yahoo.com
authors.forename: Karine
authors.initials: K
authors.lastname: Chung
authors.forename: Lewis
authors.initials: L
authors.lastname: Krey
authors.forename: Joseph
authors.initials: J
authors.lastname: Katz
authors.forename: Nicole
authors.initials: N
authors.lastname: Noyes
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors* / Q000378:metabolism; D006727:Hormone Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000378:metabolism; D007986:Luteinizing Hormone / Q000494:pharmacology / Q000627:therapeutic use*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone