The impact of LH-containing gonadotropin stimulation on euploidy rates in preimplantation embryos: antagonist cycles.
OBJECTIVE
To evaluate effects of luteinizing hormone (LH)-containing gonadotropins (human menopausal gonadotropin, hMG) on ploidy of human cleavage-stage embryos in gonadotropin releasing hormone (GnRH) antagonist cycles.


METHODS
Retrospective matched cohort study.


METHODS
Two academically affiliated private fertility centers, private preimplantation genetics laboratory, and medical school.


METHODS
One hundred four consecutive in vitro fertilization cycles (IVF) with preimplantation genetic diagnosis in women aged 30 to 45 years.


METHODS
Antagonist cycles with ovarian stimulation by either recombinant follicle stimulating hormone (FSH) alone, or in combination with human menopausal gonadotropin (FSH/hMG).


METHODS
After matching patients for age and gonadotropin dosage, embryo ploidy, pregnancy, and miscarriage rates were evaluated.


RESULTS
Euploidy rates (FSH, 29.4% vs. FSH/hMG, 25.7%) and number of euploid embryos (FSH, 2.1 +/- 1.6 vs. FSH/hMG, 1.9 +/- 1.5) were similar between both groups, although trended in favor of FSH-only stimulation. FSH-only stimulation, however, demonstrated significantly higher clinical pregnancy rates per cycle start (FSH: 34.6% vs. FSH/hMG: 11.5%) and per embryo transfer (FSH: 40% vs. FSH/hMG: 15%).


CONCLUSIONS
Because this study involved mostly women of advanced reproductive age, at least in such an age category, LH-containing stimulation causes adverse effects on pregnancy rates, although whether such an adverse effect on ploidy exists in parallel requires further investigation. These observations point toward embryo-independent adverse effects on implantation (luteal phase) in antagonist cycles with hMG costimulation.
Weghofer
Andrea
A
Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria; The Center for Human Reproduction and the Foundation for Reproductive Medicine, New York, New York. Electronic address: andrea.weghofer@meduniwien.ac.at.
Munné
Santiago
S
Reprogenetics, LLC, West Orange, New Jersey.
Brannath
Werner
W
Core Unit for Medical Statistics and Informatics, Section for Medical Statistics, Medical University Vienna, Vienna, Austria.
Chen
Serena
S
The Institute for Reproductive Medicine and Science, Livingston, New Jersey.
Barad
David
D
The Center for Human Reproduction and the Foundation for Reproductive Medicine, New York, New York.
Cohen
Jacques
J
Reprogenetics, LLC, West Orange, New Jersey.
Gleicher
Norbert
N
The Center for Human Reproduction and the Foundation for Reproductive Medicine, New York, New York; Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut.
D000022:Abortion, Spontaneous; D000328:Adult; D001755:Blastocyst / Q000187:drug effects*; D015331:Cohort Studies; D010064:Embryo Implantation / Q000187:drug effects; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D005640:Follicle Stimulating Hormone / Q000494:pharmacology*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D008596:Menotropins / Q000009:adverse effects / Q000494:pharmacology*; D008875:Middle Aged; D010062:Ovulation Induction / Q000379:methods*; D011003:Ploidies; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies
D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D005640:Follicle Stimulating Hormone