Effects of recombinant human luteinizing hormone supplementation on ovarian stimulation and the implantation rate in down-regulated women of advanced reproductive age.
OBJECTIVE
To evaluate the effects of recombinant human luteinizing hormone (rhLH) supplementation on ovarian stimulation and implantation rate in down-regulated women of advanced reproductive age.


METHODS
Prospective randomized study.


METHODS
University teaching hospital.


METHODS
A total of 120 consecutive normogonadotropic infertile women > or = 35 years old undergoing their first cycle of IVF or intracytoplasmic sperm injection (ICSI) treatment.


METHODS
Ovarian stimulation in a long agonist protocol with a combination of recombinant human follicle-stimulating hormone (rhFSH) and rhLH (group 1, n = 60) starting on day 6 of FSH stimulation until hCG at a daily fixed dose of 150 IU of rhLH, or with rhFSH alone (group 2, n = 60).


METHODS
Ovarian stimulation characteristics, ovum retrieval, and IVF/ICSI outcome.


RESULTS
The mean number of intermediate (10-14 mm) and large (> 14- < 18 mm) but not leading (> or = 18 mm) follicles was significantly lower in group 1 on the day of hCG injection. The oocyte yield and maturity as well as the number of oocytes fertilized were significantly higher in group 2 than in group 1. However, the number of patients having embryo transfer (n = 55 in both treatment groups), the number and quality of embryos replaced, the implantation rate (20.6% vs. 21.7%) and clinical pregnancy rates per embryo transfer (44% vs. 45%) were similar in groups 1 and 2.


CONCLUSIONS
The rhLH supplementation does not increase ovarian response and implantation rates in patients of older reproductive age stimulated with rhFSH under pituitary suppression for assisted reproductive technologies (ARTs).
Institut Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine-University of Barcelona, Barcelona, Spain.
Francisco
F
Fábregues
Montserrat
M
Creus
Joana
J
Peñarrubia
Dolors
D
Manau
Juan A
JA
Vanrell
Juan
J
Balasch
D000328:Adult; D015536:Down-Regulation / Q000187:drug effects / Q000502:physiology*; D010064:Embryo Implantation / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000503:physiopathology; D007986:Luteinizing Hormone / Q000494:pharmacology / Q000502:physiology / Q000627:therapeutic use*; D008423:Maternal Age; D010062:Ovulation Induction / Q000639:trends; D011247:Pregnancy; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use
D011994:Recombinant Proteins; D007986:Luteinizing Hormone