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Research paper
Published online: 2021-10-20
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The value of LH supplementation in young women with diminished ovarian reserve treated with GnRH Antagonist Protocol for ovarian hyperstimulation in ICSI-cycles

Nefise Nazlı YENIGUL1, Runa Ozelçi1, Emre Baser2, Serdar Dilbaz1, Oya Aldemir1, Berna Dilbaz1, Ozlem Moraloğlu Tekin1
DOI: 10.5603/GP.a2021.0137
Affiliations
  1. IVF Clinic of the University of Health Sciences School of Medicine, Etlik Zubeyde Hanım Research and Training Hospital, Ankara, Turkey, Turkey
  2. Yozgat Bozok University Faculty of Medicine, Department of Obstetrics and Gynecology, Yozgat, Turkey

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2021-10-20

Abstract

Objectives: To compare the success of two controlled ovarian hyperstimulation protocols; rFSH + hp-hMG with only rFSH in the GnRH antagonist protocol in diminished ovarian reserve under 35 years of age.

Material and methods: Data from January 2015 to June 2019 were abstracted from the hospital records of IVF Clinic. The women younger than 35 years of age who were diagnosed as diminished ovarian reserve and underwent standard GnRH antagonist protocol were included. Patients in Group-1 underwent controlled ovarian stimulation with rFSH alone and Group-2 with rFSH in combination with hp-hMG. Patients in both groups were divided into three subgroups according to their antral follicle count at Day 3: < 4 (a), 4–6 (b), and 7–10 (c). Demographic features and IVF outcomes of the patients were extracted.

Results: Total number of retrieved oocytes, was higher in Group-1 than Group-2 (6.5 ± 2.1 vs 5.5 ± 2.3, respectively, p < 0.001). However, there were no significant differences between the two groups in terms of clinical pregnancy rate, implantation rate, miscarriage rate and live birth rate. Although the main study outcome parameters did not show significant difference between Group-1a and Group-2a, the number of mature oocytes (5 ± 2.8 vs 1.8 ± 1.2, respectively, p = 0.006) was higher in Group-1a.

Conclusions: We observed no beneficial effect of LH supplementation during IVF for the treatment of women under 35 years old with diminished ovarian reserve in the first treatment cycle when compared with rFSH only in the antagonist protocols.

Abstract

Objectives: To compare the success of two controlled ovarian hyperstimulation protocols; rFSH + hp-hMG with only rFSH in the GnRH antagonist protocol in diminished ovarian reserve under 35 years of age.

Material and methods: Data from January 2015 to June 2019 were abstracted from the hospital records of IVF Clinic. The women younger than 35 years of age who were diagnosed as diminished ovarian reserve and underwent standard GnRH antagonist protocol were included. Patients in Group-1 underwent controlled ovarian stimulation with rFSH alone and Group-2 with rFSH in combination with hp-hMG. Patients in both groups were divided into three subgroups according to their antral follicle count at Day 3: < 4 (a), 4–6 (b), and 7–10 (c). Demographic features and IVF outcomes of the patients were extracted.

Results: Total number of retrieved oocytes, was higher in Group-1 than Group-2 (6.5 ± 2.1 vs 5.5 ± 2.3, respectively, p < 0.001). However, there were no significant differences between the two groups in terms of clinical pregnancy rate, implantation rate, miscarriage rate and live birth rate. Although the main study outcome parameters did not show significant difference between Group-1a and Group-2a, the number of mature oocytes (5 ± 2.8 vs 1.8 ± 1.2, respectively, p = 0.006) was higher in Group-1a.

Conclusions: We observed no beneficial effect of LH supplementation during IVF for the treatment of women under 35 years old with diminished ovarian reserve in the first treatment cycle when compared with rFSH only in the antagonist protocols.

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Keywords

diminished ovarian reserve; GnRH antagonist; luteinizing hormone; ovarian hyperstimulation

About this article
Title

The value of LH supplementation in young women with diminished ovarian reserve treated with GnRH Antagonist Protocol for ovarian hyperstimulation in ICSI-cycles

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-10-20

DOI

10.5603/GP.a2021.0137

Keywords

diminished ovarian reserve
GnRH antagonist
luteinizing hormone
ovarian hyperstimulation

Authors

Nefise Nazlı YENIGUL
Runa Ozelçi
Emre Baser
Serdar Dilbaz
Oya Aldemir
Berna Dilbaz
Ozlem Moraloğlu Tekin

References (21)
  1. Vuong TNL, Phung HT, Ho MT. Recombinant follicle-stimulating hormone and recombinant luteinizing hormone versus recombinant follicle-stimulating hormone alone during GnRH antagonist ovarian stimulation in patients aged ≥35 years: a randomized controlled trial. Hum Reprod. 2015; 30(5): 1188–1195.
  2. Ferraretti AP, La Marca A, Fauser BC, et al. ESHRE working group on Poor Ovarian Response Definition. ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011; 26(7): 1616–1624.
  3. Dahan MH, Agdi M, Shehata F, et al. A comparison of outcomes from in vitro fertilization cycles stimulated with either recombinant luteinizing hormone (LH) or human chorionic gonadotropin acting as an LH analogue delivered as human menopausal gonadotropins, in subjects with good or poor ovarian reserve: a retrospective analysis. Eur J Obstet Gynecol Reprod Biol. 2014; 172: 70–73.
  4. Mignini Renzini M, Brigante C, Coticchio G, et al. Retrospective analysis of treatments with recombinant FSH and recombinant LH versus human menopausal gonadotropin in women with reduced ovarian reserve. J Assist Reprod Genet. 2017; 34(12): 1645–1651.
  5. Karlström PO, Holte J, Hadziosmanovic N, et al. Does ovarian stimulation regimen affect IVF outcome? a two-centre, real-world retrospective study using predominantly cleavage-stage, single embryo transfer. Reprod Biomed Online. 2018; 36(1): 59–66.
  6. Balasch J, Creus M, Fábregues F, et al. The effect of exogenous luteinizing hormone (LH) on oocyte viability: evidence from a comparative study using recombinant human follicle-stimulating hormone (FSH) alone or in combination with recombinant LH for ovarian stimulation in pituitary-suppressed women undergoing assisted reproduction. J Assist Reprod Genet. 2001; 18(5): 250–256.
  7. Nelson SM. Biomarkers of ovarian response: current and future applications. Fertil Steril. 2013; 99(4): 963–969.
  8. Conforti A, Esteves SC, Di Rella F, et al. Correction to: The role of recombinant LH in women with hypo-response to controlled ovarian stimulation: a systematic review and meta-analysis. Reprod Biol Endocrinol. 2019; 17(1): 31.
  9. Kumar P, Sait SF. Luteinizing hormone and its dilemma in ovulation induction. J Hum Reprod Sci. 2011; 4(1): 2–7.
  10. Vaiarelli A, Cimadomo D, Ubaldi N, et al. What is new in the management of poor ovarian response in IVF? Curr Opin Obstet Gynecol. 2018; 30(3): 155–162.
  11. Lehert P, Kolibianakis EM, Venetis CA, et al. Recombinant human follicle-stimulating hormone (r-hFSH) plus recombinant luteinizing hormone versus r-hFSH alone for ovarian stimulation during assisted reproductive technology: systematic review and meta-analysis. Reprod Biol Endocrinol. 2014; 12: 17.
  12. Alviggi C, Conforti A, Esteves SC, et al. International Collaborative Group for the Study of r-hLH (iCOS-LH). Recombinant luteinizing hormone supplementation in assisted reproductive technology: a systematic review. Fertil Steril. 2018; 109(4): 644–664.
  13. Kan O, Simsir C, Atabekoglu CS, et al. The impact of adding hp-hMG in r-FSH started GnRH antagonist cycles on ART outcome. Gynecol Endocrinol. 2019; 35(10): 869–872.
  14. Younis JS, Izhaki I, Ben-Ami M. The effect of rLH supplementation to the GnRH-antagonist protocol on endocrine dynamics in the advanced reproductive age. J Endocrinol Invest. 2017; 40(8): 831–839.
  15. König TE, van der Houwen LEE, Overbeek A, et al. Recombinant LH supplementation to a standard GnRH antagonist protocol in women of 35 years or older undergoing IVF/ICSI: a randomized controlled multicentre study. Hum Reprod. 2013; 28(10): 2804–2812.
  16. Bosch E, Labarta E, Crespo J, et al. Impact of luteinizing hormone administration on gonadotropin-releasing hormone antagonist cycles: an age-adjusted analysis. Fertil Steril. 2011; 95(3): 1031–1036.
  17. Wiser A, Hourvitz A, Yinon Y, et al. Recombinant human luteinizing hormone supplementation may improve embryo quality in in vitro fertilization/intracytoplasmic sperm injection cycles with gonadotropin-releasing hormone antagonist protocol. Open Journal of Obstetrics and Gynecology. 2011; 1(2): 31–35.
  18. Borges E, Braga DP, Azevedo Md, et al. Improving implantation rate by adding recombinant LH supplementation to recombinant FSH during controlled ovarian stimulation in GnRH antagonist regimen. Fertility and Sterility. 2019; 112(3): e182.
  19. Liu M, Liu S, Li L, et al. LH levels may be used as an indicator for the time of antagonist administration in GnRH antagonist protocols-A proof-Of-concept study. Front Endocrinol (Lausanne). 2019; 10: 67.
  20. Marrs R, Meldrum D, Muasher S, et al. Randomized trial to compare the effect of recombinant human FSH (follitropin alfa) with or without recombinant human LH in women undergoing assisted reproduction treatment. Reprod Biomed Online. 2004; 8(2): 175–182.
  21. Matorras R, Prieto B, Exposito A, et al. Mid-follicular LH supplementation in women aged 35-39 years undergoing ICSI cycles: a randomized controlled study. Reprod Biomed Online. 2009; 19(6): 879–887.

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