title: Is there a Need for Luteinizing Hormone (LH) Estimation in Patients Undergoing Ovarian Stimulation with Gonadotropin-Releasing Hormone (GnRH) Antagonists and Recombinant Follicle-Stimulating Hormone (rFSH)?
abstract: OBJECTIVE
  To find out effect of serum luteinizing hormone (LH) levels on Day 1 (Day 2 of cycle) and Day 5 of stimulation and Day of trigger hCG in controlled ovulation stimulation with antagonist protocol of IVF-ICSI cycle on cycle outcome.
  
  
  METHODS
  This retrospective study was conducted in a University Hospital setting. One hundred and 62 patients underwent 165 cycles of controlled ovarian stimulation (COS) with recombinant Follicle stimulating hormone (rFSH) and Gonadotropin releasing hormone (GnRH) antagonist protocol in one year were included. Serum LH levels estimated on Day 1, Day 5 and the day of trigger hCG injections were divided into three groups based on the percentile and outcome measured.
  
  
  RESULTS
  The average number of follicles >18 mm in size were significant in the patients with LH levels between 25th to 75th percentile group on Day 1, Day 5 and Day of trigger hCG. The fertilization rate was significant (p= 0.04) in the patients with LH levels < 25thpercentile on the day of trigger hCG. Oocyte recovery rate, oocyte maturation rate and average number of best quality embryos (Grade 1) were not affected significantly in all three groups.
  
  
  CONCLUSIONS
  In GnRH antagonist and rFSH protocols, low serum LH concentrations on the day of trigger hCG has better fertilization rate. LH levels between 25th and 75th percentile have an influence on the average number of > 18 mm size follicles. However, the LH level on Day 1, Day 5 and Day of hCG does not affect the cycle outcome in COS with antagonist protocol of IVF cycle. Hence, LH estimation is not mandatory in ART cycles with GnRH antagonist protocol.
authors.affiliation: Associate Professor, Department of Obstetrics and Gynecology, Kasturba Medical College , Manipal, Karnataka 576104, India .
authors.forename: Amar
authors.initials: A
authors.lastname: Ramachandran
authors.affiliation: Junior Resident, Department of Obstetrics and Gynecology, Kasturba Medical College , Manipal, Karnataka 576104, India .
authors.forename: Kshitij
authors.initials: K
authors.lastname: Jamdade
authors.affiliation: Professor, Department of Obstetrics and Gynecology, Kasturba Medical College , Manipal, Karnataka 576104, India .
authors.forename: Pratap
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Professor, Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Kasturba Medical College , Manipal, Karnataka 576104, India .
authors.forename: Satish Kumar
authors.initials: SK
authors.lastname: Adiga
authors.affiliation: Associate Professor, Department of Obstetrics and Gynecology, Kasturba Medical College , Manipal, Karnataka 576104, India .
authors.forename: Rajeshwari G
authors.initials: RG
authors.lastname: Bhat
authors.affiliation: Junior Resident, Department of Obstetrics and Gynecology, Kasturba Medical College , Manipal, Karnataka 576104, India .
authors.forename: Sinatra R
authors.initials: SR
authors.lastname: Ferrao
keywords: Gonadotropin releasing hormone (GnRH) antagonist ligament; Luteinizing hormone; recombinant Follicle stimulating hormone (rFSH)