Human Reproduction, Vol. 16, No. 6, 1092-1097,
June 2001
© 2001 European Society of Human Reproduction and Embryology
The effect of gonadotrophins with differing LH/FSH ratios on the secretion of the various species of inhibin in women receiving IVF
1 Human Assisted Reproduction Unit, Rotunda Hospital, Dublin 1, 2 Human Assisted Reproduction Unit, Rotunda Hospital, Dublin 1, 3 Animal and Microbial Sciences, University of Reading, Reading, 4 Biological and Molecular Sciences, Oxford Brookes University, Oxford and 5 Department of Clinical Biochemistry, Hope Hospital, Stott Lane, Salford, UK
We have measured secretory patterns of inhibin A, B, total 
inhibin, pro-C inhibin and oestradiol in women following pituitary suppression who were randomised into two groups to receive either urinary gonadotrophin (25:75 IU/ampoule of luteinizing hormone (LH) and follicle stimulating hormone (FSH; Normegon; n = 11) or recombinant (r)FSH (75 IU/ampoule of FSH alone, n = 16). The women were of similar age (~33 years) and length of infertility (~4 years) and had a normal endocrine evaluation. Plasma FSH, LH, oestradiol, inhibin A, B, pro-C and total inhibin were measured by immunoassay prior to and following gonadotrophin stimulation. Immunoactive FSH, LH and oestradiol blood concentrations following pituitary down regulation were similar in the two groups being <2.0, <3.6 IU/l and <82 pmol/l respectively. The units of FSH given (2230 versus 2764 IU; Normegon versus rFSH), duration of treatment (9.1 versus 9.4 days) and number of follicles of 
14mm on the day of human chorionic gonadotrophin (HCG) administration (17 versus 14) were also similar. Inhibin A or B concentrations rose similarly during Normegon or rFSH administration, peaking at days 9–11. Total and pro-C inhibin concentrations were lower (P < 0.05) in the rFSH group during days 10 and 11 of treatment being 18.9 ± 15.9 ng/ml (Normegon) and 4.6 ± 2.8 ng/ml (rFSH) for total inhibin and 8.5 ± 6.8 ng/ml (Normegon) and 2.8 ± 1.6 ng/ml (rFSH) for pro-C inhibin on day 10. Overall, higher total inhibin concentrations were associated with more mature follicles and oocytes, greater fertilization rates and better quality embryos. We conclude that inhibin A and B secretion was similar in both groups and is primarily controlled by FSH, whereas total inhibin and pro-C increased preferentially in the Normegon group over the rFSH group, indicating that they are, in part, stimulated by LH.
Key words: Gonal-F/inhibin/Normegon/Puregon/recombinant FSH
6 To whom correspondence should be addressed at: University Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, OX3 9DU, UK. E-mail: ann.lambert{at}obs-gyn.ox.ac.uk
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