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Hum. Reprod. Advance Access originally published online on November 16, 2007
Human Reproduction 2008 23(2):427-434; doi:10.1093/humrep/dem317
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Recombinant LH supplementation to recombinant FSH during the final days of controlled ovarian stimulation for in vitro fertilization. A multicentre, prospective, randomized, controlled trial

A. NyboeAndersen1,10, P. Humaidan2, G. Fried3, J. Hausken4, L. Antila5, S. Bangsbøll1, P.E. Rasmussen6, S. Lindenberg7, H. Ejdrup Bredkjaer8, H. Meinertz The Nordic LH study group9,9

1 The Fertility clinics 4017, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark 2 Skive Hospital, Skive, Denmark 3 Karolinska University Hospital, Stockholm, Sweden 4 Haugesund Hospital, Haugesund, Norway 5 The Family Federation of Finland, Turku, Finland 6 Odense University Hospital, Odense, Denmark 7 Herlev University Hospital, Copenhagen, Denmark 8 Holbæk Hospital, Holbæk, Denmark 9 Hvidovre Hospital, Copenhagen, Denmark

10Correspondence address. Tel: +453-5451315/4976; Fax: +453-5454946; E-mail: anyboea{at}rh.hosp.dk

BACKGROUND: The purpose of this multicentre, multinational trial was to study whether rLH supplementation to recombinant FSH (rFSH) during the late follicular phase increased pregnancy rates.

METHODS: After down-regulation with nafarelin, 526 women were randomized on Day 1 of stimulation to use either rFSH (Gonal-F) alone (n = 261) or to continue after Day 6 of stimulation with both rFSH (Gonal-F) and rLH (Luveris) (n = 265) from Day 6. The starting dose of rFSH was 150–225 IU/day according to age below or above 35 years.

RESULTS: Ongoing pregnancy rate at week 10–12 was 28.7% after rFSH alone and 27.2% after rFSH + rLH. This showed no evidence of a difference. Administration of rLH significantly (P< 0.001) increased serum LH. Ongoing pregnancy rates in patients with low LH levels (<33 percentile) on Days 1 and 6 of stimulation showed no difference between the group treated with rFSH only (23.9% low Day 1 LH; 22.1% low Day 6 LH) versus rFSH + rLH (25.0% low Day 1 LH; 28.9% low Day 6 LH).

CONCLUSIONS: Supplementing rFSH with daily doses of 75–150 IU of rLH during the second half of the follicular phase showed no evidence of increasing the ongoing pregnancy rates in the general population. (ClinicalTrials.gov, trial number: KF02-035/03).


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