Exogenous Luteinizing Hormone in Controlled Ovarian Hyperstimulation for Assisted Reproduction Techniques

Objective: To investigate the role of exogenous LH in controlled ovarian hyperstimulation for assisted reproductive technologies.

Design: Prospective randomized study.

Setting: SISMER fertility unit.

Patient(s): Women showing a hyporesponsiveness to FSH under GnRH agonist down-regulation were randomized into three groups: group A (n = 54) received an increased dosage of FSH; group B (n = 54) was administered recombinant LH in addition to the increased dose of FSH; group C (n = 22) was given additional FSH and LH using hMG as a combined drug. Fifty-four age-matched women with no need to increase the FSH dose were included as a control group (D).

Intervention(s): None.

Main Outcome Measure(s): Implantation and live birth rate per started cycles.

Result(s): In group B, the pregnancy and implantation rates were statistically higher when compared with groups A and C and did not differ from the control group for normal response. The live birth rate was similar in groups B and D but was half as high in groups A and C.

Conclusion(s): Hyporesponsiveness to FSH could be related to iatrogenic LH deficiency that, in turn, could affect oocyte competence. Addition of a small amount of recombinant LH is able to rescue oocyte competence to produce viable embryos.