The decrease of serum luteinizing hormone level by a gonadotropin-releasing hormone antagonist following the mild IVF stimulation protocol for IVF and its clinical outcome.
OBJECTIVE
While performing the mild ovarian stimulation protocol with a GnRH antagonist, the pregnancy rate was compared between the groups, which were divided by the degree that the luteinizing hormone (LH) level decreased.


METHODS
Patients aged 27 to 42years (36.1 +/- 3.79) underwent 308 IVF cycles who opted for IVF via the mild ovarian stimulation protocol began clomiphene citrate on day 3 and recombinant FSH on day 5. A GnRH antagonist was administered when the dominant follicle reached 14mm. Serum LH was measured at the time of GnRH antagonist administration and at the time of hCG injection. The pregnancy rate and implantation rate were compared between 50 cycles in which the LH level dropped less than one-third and the control (LH level within 1/3).


RESULTS
The pregnancy rate for the group in which the LH level fell less than one third was 18%. Conversely, the pregnancy rate for the control group was 39%. The implantation rate was 18% for the less than one-third group and 26% for the control group. Both the pregnancy rate and the implantation rate for the group in which the LH level fell less than one-third were significantly lower than that of control (p < 0.02).


CONCLUSIONS
When performing the mild ovarian stimulation protocol, serum LH should be followed. If the serum LH level is less than one-third at the time of hCG injection, both the pregnancy rate and implantation rate are significantly lower.
Yanaihara
Atsushi
A
Denentoshi Ladies Clinic Reproductive Center, 2-3-10-5F Aoba-ku, Yokohama-shi, Kanagawa 227-0062, Japan. yanaihara@med.showa-u.ac.jp
Yorimitsu
Takeshi
T
Motoyama
Hiroshi
H
Ohara
Motohiro
M
Kawamura
Toshihiro
T
D000328:Adult; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology*; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors* / Q000494:pharmacology; D006062:Gonadotropins / Q000378:metabolism; D006727:Hormone Antagonists / Q000494:pharmacology*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000037:antagonists & inhibitors / Q000097:blood*; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D006062:Gonadotropins; D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; C062876:cetrorelix