title: Evaluation of two doses of recombinant human luteinizing hormone supplementation in down-regulated women of advanced reproductive age undergoing follicular stimulation for IVF: a randomized clinical study.
abstract: OBJECTIVE
  To evaluate the effects of mid-follicular recombinant human luteinizing hormone (rhLH) supplementation in down-regulated women of advanced reproductive age undergoing in vitro fertilization (IVF).
  
  
  METHODS
  This was a prospective, randomized parallel-group study (allocation 1:1) including 187 normogonadotrophic infertile patients aged ≥ 35 years. Subcutaneous triptorelin was used for pituitary desensitization, and ovarian stimulation was achieved with recombinant human follicle-stimulating hormone (rhFSH) either alone (Group 1) or in combination with rhLH in one of two daily doses: 37.5 IU (Group 2) or 75 IU (Group 3). Ovarian stimulation characteristics and IVF outcome were evaluated. The main outcome was pregnancy rate.
  
  
  RESULTS
  A total of 62, 62 and 63 patients were randomized to groups 1, 2 and 3 respectively, and 56, 54 and 55 patients respectively were available for final analysis of the results. Follicular development and oocyte yield were significantly higher in group 1 patients compared with patients in groups 2 and 3. Oocyte maturity and number of oocytes fertilized were also higher in group 1 patients; this difference almost reached statistical significance. No significant difference in implantation and clinical pregnancy rates was found among the three treatment groups.
  
  
  CONCLUSIONS
  rhLH supplementation is not a useful tool for patients of advanced reproductive age in ovarian stimulation protocols using an appropriate gonadotrophin-releasing hormone agonist and a step-down regimen of rhFSH.
authors: Institut Clínic of Gynaecology, Obstetrics and Neonatology, Hospital Clínic-Institut d́Investigacions Biomèdiques August Pi i Sunyer, Faculty of Medicine, University of Barcelona, C/Casanova 143, 08036 Barcelona, Spain.
authors: Francisco
authors: F
authors: Fábregues
authors: Ainara
authors: A
authors: Iraola
authors: Gemma
authors: G
authors: Casals
authors: Montserrat
authors: M
authors: Creus
authors: Francisco
authors: F
authors: Carmona
authors: Juan
authors: J
authors: Balasch