title: Circulating luteinizing hormone level after triggering oocyte maturation with GnRH agonist may predict oocyte yield in flexible GnRH antagonist protocol.
abstract: BACKGROUND
  The use of gonadotrophin-releasing hormone (GnRH) agonist for triggering final oocyte maturation and ovulation can reduce ovarian hyperstimulation syndrome (OHSS) in high-risk patients. LH levels post-trigger with GnRH agonist might be correlated with oocyte yield and maturity. Our aim was to evaluate the relationship between serum LH level at 12-h post-trigger and oocyte yield, maturity and fertilization rate in patients at high risk of OHSS and therefore who were treated with a flexible GnRH antagonist protocol in which final oocyte maturation was triggered with GnRH agonist.
  
  
  METHODS
  In a prospective cohort study, 91 patients at high risk of OHSS were treated with a flexible GnRH antagonist protocol and divided into six groups according to their serum LH levels at 12-h after GnRH agonist administration: ≤15.0, 15.1-30.0, 30.1-45.0, 45.1-60.0, 60.1-75.0 and >75.0 IU/l. The oocyte yield, maturity, fertilization rate and clinical outcomes for each LH interval were analyzed.
  
  
  RESULTS
  There was a statistically significant reduction in oocyte yield with a concentration of serum LH ≤15.0 IU/l (P < 0.05), whereas no statistically significant differences in the oocyte maturity and fertilization rate among the six groups (P > 0.05) were seen. Only 5 out of 91 patients (5.5%) had a serum LH ≤15.0 IU/l at 12-h post-trigger with GnRH agonist. In addition, no statistically significant difference was seen regarding high-quality embryos, implantation rate, clinical pregnancy rate and early miscarriage between patients with LH ≤15.0 IU/l and >15.0 IU/l (P > 0.05).
  
  
  CONCLUSIONS
  Serum LH level at 12-h post-trigger with GnRHa <15.0 IU/l is associated with a dramatically lower oocyte yield but not with the oocyte maturity and fertilization rate. Serum LH levels post-trigger with GnRH agonist do not affect clinical outcomes.
authors.affiliation: Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China. chensl_92@163.com
authors.forename: Shi-Ling
authors.initials: SL
authors.lastname: Chen
authors.forename: De-Sheng
authors.initials: DS
authors.lastname: Ye
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.forename: Xin-Hong
authors.initials: XH
authors.lastname: Yang
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Zheng
authors.forename: Yan
authors.initials: Y
authors.lastname: Tang
authors.forename: Yu-Xia
authors.initials: YX
authors.lastname: He
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
mesh_terms: D000328:Adult; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D009865:Oocytes / Q000187:drug effects; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone