title: The use of recombinant luteinizing hormone in patients undergoing assisted reproductive techniques with advanced reproductive age: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the effect of recombinant LH in assisted reproduction technology (ART) cycles in patients of advanced reproductive age.
  
  
  METHODS
  A systematic review and meta-analysis.
  
  
  METHODS
  Published randomized controlled clinical trials comparing recombinant LH plus recombinant FSH versus recombinant FSH only in patients of advanced reproductive age.
  
  
  METHODS
  Patients 35 years and older undergoing assisted reproduction.
  
  
  METHODS
  Recombinant LH plus recombinant FSH controlled ovarian hyperstimulation (COH) versus recombinant FSH stimulation only in assisted reproduction cycles.
  
  
  METHODS
  Implantation and clinical pregnancy.
  
  
  RESULTS
  Seven trials were identified that met inclusion criteria and comprised 902 assisted reproduction technology cycles. No differences in serum E(2) on the day of hCG administration were reported in any trials. Two trials reported lower oocyte yield and one trial reported lower metaphase II oocyte yield in the recombinant LH-supplemented group. One trial reported higher fertilization rates in the recombinant LH-supplemented group. In a fixed effect model, implantation was higher in the recombinant LH-supplemented group (odds ratio 1.36, 95% confidence interval 1.05-1.78). Similarly, clinical pregnancy was increased in the recombinant LH-supplemented group (odds ratio 1.37, 95% confidence interval 1.03-1.83).
  
  
  CONCLUSIONS
  The addition of recombinant LH to ART cycles may improve implantation and clinical pregnancy in patients of advanced reproductive age.
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA.
authors.forename: Micah J
authors.initials: MJ
authors.lastname: Hill
authors.forename: Eric D
authors.initials: ED
authors.lastname: Levens
authors.forename: Gary
authors.initials: G
authors.lastname: Levy
authors.forename: Mary E
authors.initials: ME
authors.lastname: Ryan
authors.forename: John M
authors.initials: JM
authors.lastname: Csokmay
authors.forename: Alan H
authors.initials: AH
authors.lastname: DeCherney
authors.forename: Brian W
authors.initials: BW
authors.lastname: Whitcomb
mesh_terms: D000328:Adult; D000367:Age Factors; D000375:Aging; D004359:Drug Therapy, Combination; D010064:Embryo Implantation; D019317:Evidence-Based Medicine; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007986:Luteinizing Hormone / Q000627:therapeutic use*; D016017:Odds Ratio; D054315:Oocyte Retrieval; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000627:therapeutic use; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D011994:Recombinant Proteins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone