Human Reproduction, Vol. 18, No. 12, 2689-2697,
December 2003
© 2003 European Society of Human Reproduction and Embryology
LH serum levels during ovarian stimulation as predictors of ovarian response and assisted reproduction outcome in down-regulated women stimulated with recombinant FSH
1 Institut Clinic of Gynecology, Obstetrics and Neonatology and 2 Hormonal Laboratory, Faculty of Medicine–University of Barcelona, Hospital Clinic-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
3 To whom correspondence should be addressed at: Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic; C/Casanova 143, 08036 Barcelona, Spain. e-mail: jbalasch{at}medicina.ub.es
BACKGROUND: There has been much debate about the effect of ‘residual’ LH levels in normogonadotrophic women undergoing assisted reproduction with GnRH agonist down-regulation and recombinant FSH ovarian stimulation. The aim of this prospective study, where receiver-operating characteristic (ROC) analysis was used, was to assess further the usefulness of serum LH levels as predictors of ovarian response, assisted reproduction treatment outcome, and the outcome of pregnancy when measured throughout the ovarian stimulation period in a large cohort of such assisted reproduction treatment women. METHODS: A total of 246 consecutive women undergoing their first cycle of IVF or ICSI treatment were included in this study. Blood samples for hormone analyses were obtained on day S0 (the day when pituitary suppression was evidenced) and every other day from stimulation day 5 (S5) until the day of hCG injection. RESULTS: LH serum levels throughout ovarian stimulation treatment were similar for cancelled (n =32) versus non-cancelled (n = 214) cycles, non-conception (n = 132) versus conception (n = 82) cycles, and ongoing pregnancy (n = 66) versus early pregnancy loss (n = 16) groups. There was no correlation between LH serum levels in non-cancelled cycles and parameters of ovarian response and assisted reproduction treatment outcome. ROC analysis showed that serum LH concentration during ovarian stimulation was unable to discriminate between cancelled and non-cancelled cycles, conception versus non-conception cycles, or early pregnancy loss versus ongoing pregnancy groups. CONCLUSIONS: Serum LH measurements during ovarian stimulation with recombinant FSH under pituitary suppression in normogonadotrophic women undergoing assisted reproduction treatment cannot predict ovarian response, IVF/ICSI outcome, implantation, and the outcome of pregnancy. Thus, there is little underlying physiological support for the addition of LH in stimulation protocols if daily doses of an appropriate GnRH agonist (leuprolide or triptorelin having lower potency than buserelin) and a step-down regimen of recombinant FSH administration are used.
Key words: assisted reproduction/early pregnancy loss/recombinant FSH/LH/ovarian stimulation
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Weghofer and N. Gleicher Ovarian function: a theory of relativity Hum. Reprod., January 1, 2009; 24(1): 17 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B.C.J.M. Fauser, K. Diedrich, P. Devroey, and on behalf of the Evian Annual Reproduction (EVAR) Predictors of ovarian response: progress towards individualized treatment in ovulation induction and ovarian stimulation Hum. Reprod. Update, January 1, 2008; 14(1): 1 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.A. Huirne, R. Homburg, and C.B. Lambalk Are GnRH antagonists comparable to agonists for use in IVF? Hum. Reprod., November 1, 2007; 22(11): 2805 - 2813. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Safdarian, F. S. Mohammadi, A. Alleyassin, M. Aghahosseini, A. Meysamie, and E. Rahimi Clinical outcome with half-dose depot triptorelin is the same as reduced-dose daily buserelin in a long protocol of controlled ovarian stimulation for ICSI/embryo transfer: a randomized double-blind clinical trial (NCT00461916) Hum. Reprod., September 1, 2007; 22(9): 2449 - 2454. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Balasch, F. Fabregues, J. Penarrubia, F. Carmona, R. Casamitjana, M. Creus, D. Manau, G. Casals, and J. A. Vanrell Pretreatment with transdermal testosterone may improve ovarian response to gonadotrophins in poor-responder IVF patients with normal basal concentrations of FSH Hum. Reprod., July 1, 2006; 21(7): 1884 - 1893. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. S. Macklon, R. L. Stouffer, L. C. Giudice, and B. C. J. M. Fauser The Science behind 25 Years of Ovarian Stimulation for in Vitro Fertilization Endocr. Rev., April 1, 2006; 27(2): 170 - 207. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Griesinger, A. Schultze-Mosgau, K. Dafopoulos, A. Schroeder, A. Schroer, S. von Otte, D. Hornung, K. Diedrich, and R. Felberbaum Recombinant luteinizing hormone supplementation to recombinant follicle-stimulating hormone induced ovarian hyperstimulation in the GnRH-antagonist multiple-dose protocol Hum. Reprod., May 1, 2005; 20(5): 1200 - 1206. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Penarrubia, F. Fabregues, D. Manau, M. Creus, G. Casals, R. Casamitjana, F. Carmona, J. A. Vanrell, and J. Balasch Basal and stimulation day 5 anti-Mullerian hormone serum concentrations as predictors of ovarian response and pregnancy in assisted reproductive technology cycles stimulated with gonadotropin-releasing hormone agonist-gonadotropin treatment Hum. Reprod., April 1, 2005; 20(4): 915 - 922. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Penarrubia, F. Fabregues, D. Manau, M. Creus, F. Carmona, R. Casamitjana, J. A. Vanrell, and J. Balasch Previous cycle cancellation due to poor follicular development as a predictor of ovarian response in cycles stimulated with gonadotrophin-releasing hormone agonist-gonadotrophin treatment Hum. Reprod., March 1, 2005; 20(3): 622 - 628. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Cedrin-Durnerin, D. Grange-Dujardin, A. Laffy, I. Parneix, N. Massin, J. Galey, L. Theron, J.P. Wolf, C. Conord, P. Clement, et al. Recombinant human LH supplementation during GnRH antagonist administration in IVF/ICSI cycles: a prospective randomized study Hum. Reprod., September 1, 2004; 19(9): 1979 - 1984. [Abstract] [Full Text] [PDF]
|
|