Outcome of in vitro fertilization in patients with proven poor ovarian responsiveness after early vs. mid-follicular LH exposure: a prospective, randomized, controlled study.
OBJECTIVE
To compare early vs. mid-follicular exposure to LH in patients with poor ovarian responsiveness undergoing in vitro fertilization (IVF).


METHODS
Prospective, randomized, controlled trial.


METHODS
University Hospital, University-affiliated private Clinic.


METHODS
Five hundred-thirty women with poor ovarian responsiveness during the first IVF cycle, undergoing their second IVF attempt.


METHODS
In a GnRH-analogue long protocol, ovarian stimulation with recombinant FSH (300 IU/day) plus randomly assigned addition of recombinant LH (150 IU/day) from day 1 (early LH exposure; n = 264) or from day 7 (late LH exposure; n = 266).


METHODS
Primary outcome was the number of oocytes retrieved. Secondary outcomes were: cancellation rate, total gonadotropin dose, duration of ovarian stimulation, number of embryos available for transfer, pregnancy rate per started cycle, per OPU and per embryo transfer, implantation rate, delivered/ongoing pregnancy rate.


RESULTS
Apart from the totally administered LH dose, that was significantly higher in the group receiving it from day 1, all parameters related to IVF outcome were non significantly different in the two groups.


CONCLUSIONS
Adding LH to FSH from day 1 or from day 7 of ovarian stimulation in a GnRH-agonist long protocol exerts comparable effects on IVF outcome in poor responders.
Physiopathology of Reproduction and IVF Unit, S. Anna Hospital, University of Torino, Via Ventimiglia 3, Turin, Italy. AERRE99@YAHOO.COM
Alberto
A
Revelli
Alessandra
A
Chiado'
Daniela
D
Guidetti
Francesca
F
Bongioanni
Valentina
V
Rovei
Gianluca
G
Gennarelli
D000328:Adult; D004624:Embryo Transfer / Q000379:methods; D004622:Embryo, Mammalian / Q000187:drug effects; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007986:Luteinizing Hormone / Q000008:administration & dosage / Q000627:therapeutic use; D054315:Oocyte Retrieval / Q000379:methods; D010053:Ovary / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
D011994:Recombinant Proteins; D019382:Human Growth Hormone; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone