A relative reduction in mid-follicular LH concentrations during GnRH agonist IVF/ICSI cycles leads to lower live birth rates
Authors: Lahoud, R.; Jefout, M.Al-; Tyler, J.; Ryan, J.; Driscoll, G.
Source: Human Reproduction, Volume 21, Number 10, October 2006 , pp. 2645-2649(5)
Publisher: Oxford University Press
Abstract:BACKGROUND: The effect of early- and mid-follicular LH concentrations on the ovarian response and pregnancy outcomes was evaluated in women receiving pituitary down-regulation with a GnRH agonist and ovarian stimulation with recombinant FSH (rFSH) during IVF/ICSI treatment. METHODS: Blood samples were collected prospectively from 701 cycles (560 patients) of assisted reproduction and analysed retrospectively. On the basis of LH concentrations on stimulation day 7/8, the patients were divided into two groups: LH < 1.2 IU/l (n = 179) and LH ≥ 1.2 IU/l (n = 522). Cycle outcomes were also compared on the basis of a ratio of mid- to early-follicular LH concentrations (≤0.5, n = 210; >0.5, n = 491). RESULTS: Patients with low LH concentrations were found to have a significant reduction in the late-follicular estradiol concentrations (P < 0.001), the number of oocytes retrieved (P < 0.01) and the number of usable embryos (P < 0.01), and they required significantly more rFSH (430 IU difference, P < 0.01). These differences did not translate into a significant change in live birth rates. Conversely, a ratio of ≤0.5 mid- to early-follicular LH concentrations (a reduction of ≥50%) was associated with a significant reduction in live birth rates per embryo transfer and per cycle started (27.3 versus 19.0%, P < 0.05 and 22.2 versus 15.8%, P < 0.05, respectively). CONCLUSIONS: Low mid-follicular levels of LH have a significant impact on ovarian response but not on live birth rates. A fall in LH level of ≥50% from the early- to mid-follicular phase resulted in a lower live birth rate.
Document Type: Research Article
Publication date: October 2006
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.