Human Reproduction, Vol 13, 1788-1792, Copyright © 1998 by Oxford University Press
R Fleming, F Lloyd, M Herbert, J Fenwick, T Griffiths and A Murdoch
The effects of profound suppression of circulating luteinizing hormone (LH)
during the follicular phase of in-vitro fertilization cycles were explored
in normal women during treatment with a gonadotrophin- releasing hormone
analogue and exogenous purified follicle stimulating hormone. Ovarian
responses to treatment and the capacity of supernumerary embryos to undergo
blastocyst formation were examined in groups of patients defined by the
concentration of plasma LH in the mid- follicular phase. Concentrations
< or = 0.5 IU/I diagnosed the group with profoundly suppressed LH
(<LH, n = 20), which was compared with the remaining patients (nLH, n =
41). The <LH group showed lower oestradiol concentrations at human
chorionic gonadotrophin administration, while the total follicular
development estimated by the total follicular diameters was similar in both
groups. The oestradiol secreted per follicle, estimated by the circulating
concentration per mm total follicular diameter, was significantly lower in
the <LH group. The combined effects of a trend to lower yield of oocytes
(not significant) and a lower fertilization rate (not significant) resulted
in a significantly reduced quantity of embryos available for
cryopreservation after the fresh transfer. Supernumerary embryos were
cultured for 7 days to determine blastocyst development rates, and the
degree of LH suppression made no difference to embryo developmental
competence (nLH, 23%; <LH, 27%), or the rates of blastocyst formation.
The group of patients with profoundly suppressed mid-follicular phase LH
showed a reduced yield of oocytes and embryos which resulted in
significantly fewer embryos available for cryopreservation. However, the
developmental potential of those embryos, represented by the ability to
form blastocysts in vitro, was unaffected.
ARTICLES
Effects of profound suppression of luteinizing hormone during ovarian stimulation on follicular activity, oocyte and embryo function in cycles stimulated with purified follicle stimulating hormone
University Department of Obstetrics and Gynaecology, Royal Infirmary, Glasgow, UK.
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