Impact of luteinizing hormone administration on gonadotropin-releasing hormone antagonist cycles: an age-adjusted analysis.
OBJECTIVE
To analyze the impact of LH administration on cycle outcome in ovarian stimulation with GnRH antagonists.


METHODS
Randomized, open-label, controlled trial performed in two age subgroups. Recombinant (r) FSH versus rFSH + rLH administration was compared.


METHODS
University-affiliated private infertility clinic.


METHODS
Up to 35 years old (n = 380) and aged 36 to 39 years (n = 340), undergoing their first or second IVF cycle.


METHODS
Recombinant LH administration since stimulation day 1.


METHODS
Implantation rate, ongoing pregnancy rate.


RESULTS
In the young population, implantation rates were similar: 27.8% versus 28.6%, odds ratio (OR) 1.03 (95% confidence interval [CI] 0.73-1.47), as was the ongoing pregnancy rate per started cycle: 37.4% versus 37.4%, OR 1.0 (95% CI 0.66-1.52). In older patients, the implantation rate was significantly higher in the rFSH + rLH group: 26.7% versus 18.6%, OR 1.56 (95% CI 1.04-2.33). Ongoing pregnancy rates per started cycle were 33.5% versus 25.3%, OR 1.49 (95% CI 0.93-2.38).


CONCLUSIONS
Recombinant LH administration significantly increased the implantation rate in patients aged 36 to 39 years. A clinically relevant better ongoing pregnancy rate per started cycle was observed, although the difference was not statistically significant. Patients younger than 36 years do not obtain any benefit from rLH administration.
Instituto Valenciano de Infertilidad, Valencia, Spain. ebosch@ivi.es
Ernesto
E
Bosch
Elena
E
Labarta
Juana
J
Crespo
Carlos
C
Simón
José
J
Remohí
Antonio
A
Pellicer
D000328:Adult; D004359:Drug Therapy, Combination; D010064:Embryo Implantation; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000008:administration & dosage*; D008423:Maternal Age; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000008:administration & dosage; D020554:Sperm Injections, Intracytoplasmic
D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone