title: LH supplementation in mild stimulations cycles without pituitary suppression: a retrospective analysis.
abstract: A cohort of patients addressed to a mild stimulation protocol was retrospectively analysed aiming at evaluating the effect of a luteinizing hormone (LH) activity containing stimulation compared to a pure follicle-stimulating hormone (FSH) drive in absence of any pituitary suppression. Due to a referral bias, the two groups (human FSH (hFSH) n = 210; hMG n = 105) were imbalanced for age with the hFSH group (mean age 38.4) being significantly older than the hMG group (mean age 36.8). But the clinical pregnancy rates (20%) did not differ between the groups. Secondary outcome variables showed a higher number of oocytes retrieved (3.02 vs. 2.31) and higher estradiol levels (1148 vs. 820) in the hMG/younger group whereas the fertilization rate (FR) was higher (54.8 vs. 63.8) in the FSH older/group. In spite of the LH content in the hMG product (~10 IU per vial), the LH concentration on the day of human chorionic gonadotropin (hCG) was higher, although non-significantly, in the hFSH group. We suppose hCG contained in hMG inhibited to some extent the natural release of LH from the non-suppressed pituitary. Concluding, the mild stimulation clinical pregnancy rates are satisfactory independently of the treatment choice. The hMG group showed a trend for a lower efficacy. This phenomenon might be limited to non suppressed cycles, but should be taken in due account also when designing full dose controlled ovarian hyperstimulation (COH) treatments.
authors.affiliation: Fertility Centre of La Carità Hospital, Locarno, Switzerland. mizarparagona@libero.it
authors.forename: Mizar
authors.initials: M
authors.lastname: Paragona
authors.forename: Matteo
authors.initials: M
authors.lastname: Rossini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Dattilo
authors.forename: Juerg
authors.initials: J
authors.lastname: Stamm
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000009:adverse effects / Q000494:pharmacology; D015331:Cohort Studies; D004338:Drug Combinations; D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects* / Q000494:pharmacology; D005307:Fertilization in Vitro; D043373:Follicle Stimulating Hormone, Human / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007558:Italy / Q000453:epidemiology; D007986:Luteinizing Hormone / Q000009:adverse effects* / Q000494:pharmacology; D008596:Menotropins / Q000009:adverse effects / Q000494:pharmacology; D018587:Oocyte Donation; D054315:Oocyte Retrieval; D010053:Ovary / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D010902:Pituitary Gland / Q000187:drug effects*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D006063:Chorionic Gonadotropin; D004338:Drug Combinations; D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; C527545:hMG-IBSA; D008596:Menotropins; D007986:Luteinizing Hormone