Clinical effects of ovulation induction with recombinant follicle-stimulating hormone supplemented with recombinant luteinizing hormone or low-dose recombinant human chorionic gonadotropin in the midfollicular phase in microdose cycles in poor responders.
OBJECTIVE
To assess the clinical effects of recombinant luteinizing hormone (LH) or low-dose recombinant human chorionic gonadotropin (hCG) supplementation administered in the midfollicular phase in microdose gonadotropin-releasing hormone analogue (GnRH-a) flare-up cycles.


METHODS
Prospective randomized study.


METHODS
Private infertility clinic.


METHODS
A total of 170 women enrolled, with 145 women eligible for randomization.


METHODS
After randomization, 51 patients (group A) received only 600 IU of recombinant follicle-stimulating hormone (FSH) as the control group, 46 patients (group B) received 600 IU of recombinant FSH plus daily supplementation with 75 IU of recombinant luteinizing hormone, and 48 patients (group C) received 600 IU of recombinant FSH plus daily supplementation with 75 IU of recombinant hCG.


METHODS
Peak estradiol (E(2)) levels, days of stimulation with recombinant FSH, total recombinant FSH dosage, metaphase II oocytes retrieved, pregnancy rate (positive hCG levels), clinical pregnancy rate (positive fetal cardiac activity), and cancellation rates of stimulation and embryo transfer.


RESULTS
The pregnancy rates were 35.1%, 27.6% and 31.2% for groups A, B, and C, respectively. Clinical pregnancy rates were 27.1%, 27.5, and 21.8% for groups A, B, and C, respectively. There were no statistically significant differences in the age, peak serum E(2) concentration, total recombinant FSH dosage, days of stimulation with recombinant FSH, total number of metaphase II oocytes retrieved, number of embryos transferred, pregnancy rates, clinical pregnancy rates, or cancellation rates of stimulation and embryo transfer among the three groups.


CONCLUSIONS
Additional exogenous LH activity in the form of either recombinant luteinizing hormone or low-dose recombinant hCG is unnecessary in microdose cycles to increase pregnancy rates.
Berkkanoglu
Murat
M
Antalya In Vitro Fertilization, Antalya, Turkey. mberkkan@hotmail.com <mberkkan@hotmail.com>
Isikoglu
Mete
M
Aydin
Donay
D
Ozgur
Kemal
K
D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D005498:Follicular Phase / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007986:Luteinizing Hormone / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy / Q000706:statistics & numerical data; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use
D006063:Chorionic Gonadotropin; D011994:Recombinant Proteins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone