Results with Early Follicular Phase Recombinant Luteinizing Hormone Supplementation During Stimulation for in Vitro Fertilization

Objective: To study the effect of early follicular phase recombinant LH supplementation on stimulation outcome among women undergoing IVF using the GnRHa long protocol and recombinant FSH.

Design: Randomized, controlled trial.

Setting: Private IVF unit.

Patient(s): Women under the age of 40 with normal ovarian function undergoing their first or second IVF cycle.

Intervention(s): All stimulations followed the standard luteal long GnRHa down-regulation protocol. At suppression, patients in the experimental group received 75 IU of rLH daily for 4 days, and recombinant FSH at a fixed starting dose of 150 IU for the first 5 days was started a day later, on day 2 of rLH. In the control group, patients started rFSH at a fixed dose of 150 IU for the first 5 days at suppression.

Main Outcome Measure(s): Baseline, stimulation, embryology parameters, and treatment outcome were compared. Of primary interest, recombinant FSH need during stimulation was assessed.

Result(s): Stimulation, embryology parameters, and treatment outcome were comparable. The amount of gonadotropins used and medication expense were similar in the two groups.

Conclusion(s): Early follicular phase recombinant LH supplementation at a daily dose of 75 IU does not improve response to stimulation among normal responder women undergoing IVF.