title: Is a premature rise in luteinizing hormone in the absence of increased progesterone levels detrimental to pregnancy outcome in GnRH antagonist in vitro fertilization cycles.
abstract: OBJECTIVE
  To determine whether a premature rise in the level of luteinizing hormone (LH) without a concomitant increase in the level of progesterone is detrimental to pregnancy outcome in flexible gonadotropin-releasing hormone (GnRH) antagonist in vitro fertilization (IVF) cycles.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Large academic IVF practice.
  
  
  METHODS
  All women undergoing their first GnRH-antagonist in vitro fertilization cycle at the University of Pittsburgh Medical Center between January 1, 2007, and October 1, 2010.
  
  
  METHODS
  None.
  
  
  METHODS
  Primary outcome measures included the overall pregnancy rate, live-birth/ongoing pregnancy rate, and early pregnancy loss compared between cycles with and without a premature rise in the LH level; secondary outcome measures included the number of oocytes retrieved and embryos obtained during the cycle.
  
  
  RESULTS
  Overall, 451cycles were included in the analysis. Patients who experienced a premature rise in LH had improved ovarian reserve parameters and had more oocytes retrieved compared with patients who did not experience an LH rise. However, the premature rise in LH was associated with a decreased ongoing pregnancy rate despite these improvements in cycle parameters.
  
  
  CONCLUSIONS
  The incidence of premature LH rise without a concomitant progesterone increase is more common than previously reported and is associated with decreased rates of ongoing pregnancy.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. serena.dovey@gmail.com
authors.forename: Serena
authors.initials: S
authors.lastname: Dovey
authors.forename: Kerri
authors.initials: K
authors.lastname: McIntyre
authors.forename: Debbie
authors.initials: D
authors.lastname: Jacobson
authors.forename: Janet
authors.initials: J
authors.lastname: Catov
authors.forename: Anthony
authors.initials: A
authors.lastname: Wakim
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004624:Embryo Transfer / Q000706:statistics & numerical data; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods* / Q000706:statistics & numerical data; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000097:blood / Q000628:therapy*; D007986:Luteinizing Hormone / Q000097:blood*; D008297:Male; D010062:Ovulation Induction / Q000379:methods / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood*; D012189:Retrospective Studies
chemical_list: D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D007986:Luteinizing Hormone