title: Recombinant LH supplementation in patients with a relative reduction in LH levels during IVF/ICSI cycles: A prospective randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study was to assess the use of recombinant luteinizing hormone (rLH) supplementation in patients who experience a reduction in LH concentration during controlled ovarian hyperstimulation (COH) for IVF/ICSI.
  
  
  METHODS
  A multi-center prospective randomized controlled trial (RCT) was performed over three years. Two hundred and forty patients aged between 24 and 42 years undergoing IVF/ICSI treatment with a long down regulation (LDR) protocol were recruited. LH was measured on the day FSH was started and again 6days later. 100 patients had a 50% or greater reduction in LH levels and these were randomized to receive either recombinant LH (rLH) supplementation (group 1, n=43) or no additional rLH supplementation (group 2, n=57). Group 1 received rLH 75IU daily from day 7 of FSH stimulation to the day of HCG trigger.
  
  
  RESULTS
  There were no differences in either live birth or clinical pregnancy rates per embryo transfer between the two groups (27.8% vs. 37.0%, p=0.39, RR=0.75, 95%CI 0.39-1.44 and 36.1% vs. 43.5% p=0.51, RR=0.84, 95%CI 0.5-1.48, respectively).
  
  
  CONCLUSIONS
  In conclusion the addition of rLH in patients with a relative reduction in serum LH concentration during COH for IVF/ICSI did not improve live birth or clinical pregnancy rates. However the results were not conclusive and further large well-designed RCTs are required to confirm these findings.
authors.affiliation: IVFAustralia, Level 2, 176 Pacific Hwy, Greenwich, 2065, NSW, Australia. Electronic address: rlahoud@ivf.com.au.
authors.forename: Robert
authors.initials: R
authors.lastname: Lahoud
authors.affiliation: Fertility Specialists of WA, 25 Queenslea Drive, Claremont, 6010, WA, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Ryan
authors.affiliation: IVFAustralia, Level 2, 176 Pacific Hwy, Greenwich, 2065, NSW, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Illingworth
authors.affiliation: IVFAustralia, Level 2, 176 Pacific Hwy, Greenwich, 2065, NSW, Australia.
authors.forename: Frank
authors.initials: F
authors.lastname: Quinn
authors.affiliation: IVFAustralia, Level 2, 176 Pacific Hwy, Greenwich, 2065, NSW, Australia; Obstetrics and Gynaecology, University of New South Wales and Royal Hospital for Women, Sydney, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Costello
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007986:Luteinizing Hormone / Q000008:administration & dosage* / Q000097:blood; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies
chemical_list: D007986:Luteinizing Hormone
keywords: Controlled ovarian hyperstimulation; IVF; Low LH; RCT; Recombinant LH