Hypersecretion of Basal Luteinizing Hormone and an Increased Risk of Pregnancy Loss Among Women with Polycystic Ovary Syndrome Undergoing Controlled Ovarian Stimulation and Intrauterine Insemination

Overview

Journal Heliyon

Specialty Social Sciences

Date 2023 May 26

PMID 37234655

Authors

Bin Wang

Zhiling Li

Affiliations

Soon will be listed here.

Abstract

Introduction: The relationship between basal luteinizing hormone (LH) and reproductive outcomes in women with polycystic ovary syndrome (PCOS) undergoing intrauterine insemination (IUI) has remained largely unknown, warranting further investigations. Accordingly, this study aimed to investigate the possible association of basal LH with reproductive outcomes in women with PCOS women undergoing IUI to gain a better understanding of this topic.

Material And Methods: Data from 533 cycles of controlled ovarian stimulation (COS) and IUI treatments from PCOS women were retrospectively analyzed. Statistical methods, including univariate analysis, receiver operating characteristic (ROC) curve, quartile division, and Spearman rank correlation analysis, were utilized.

Results: Basal LH resulted as the most significant contributor to pregnancy (P < 0.001). ROC analysis revealed that the predictive power of basal LH on pregnancy was stronger compared to other factors (areas under the curve 0.614, 95% CI 0.558-0.670, P = 0.000). Analysis based on quartile division unveiled a stair-shaped relation of basal LH with pregnancy or live birth as well as a positive linear relation between basal LH and early miscarriage (all P trend<0.05). Basal LH of 11.69 mIU/ml was the point above which early miscarriage grew significantly while pregnancies and live births ceased to increase. Moreover, basal LH was positively correlated with antral follicle count (AFC), number of mature follicles on the trigger day, clinical pregnancy, live birth, and multiple pregnancies (all P < 0.05). The number of mature follicles on the trigger day was positively correlated with clinical pregnancy, early miscarriage, and multiple pregnancies (all P < 0.05). AFC was positively correlated with clinical pregnancy (P < 0.05).

Conclusion: Hypersecretion of basal LH was associated with an increased risk of pregnancy loss among PCOS women undergoing COS and IUI. Basal LH may have predictive value on pregnancy achievement in women with PCOS undergoing COS and IUI.

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References

Norman R, Dewailly D, Legro R, Hickey T . Polycystic ovary syndrome. Lancet. 2007; 370(9588):685-97. DOI: 10.1016/S0140-6736(07)61345-2. View

Hunter R, Cook B, Baker T . Dissociation of response to injected gonadotropin between the Graafian follicle and oocyte in pigs. Nature. 1976; 260(5547):156-8. DOI: 10.1038/260156a0. View

Costello M, Misso M, Balen A, Boyle J, Devoto L, Garad R . Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility. Hum Reprod Open. 2019; 2019(1):hoy021. PMC: 6396642. DOI: 10.1093/hropen/hoy021. View

Le M, Le V, Le D, Nguyen V, Chen C, Cao N . Exploration of the role of anti-Mullerian hormone and LH/FSH ratio in diagnosis of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2019; 90(4):579-585. DOI: 10.1111/cen.13934. View

Sun L, Ye J, Wang Y, Chen Q, Cai R, Fu Y . Elevated basal luteinizing hormone does not impair the outcome of human menopausal gonadotropin and medroxyprogesterone acetate treatment cycles. Sci Rep. 2018; 8(1):13835. PMC: 6138741. DOI: 10.1038/s41598-018-32128-4. View

. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004; 81(1):19-25. DOI: 10.1016/j.fertnstert.2003.10.004. View

Homburg R, Armar N, Eshel A, Adams J, Jacobs H . Influence of serum luteinising hormone concentrations on ovulation, conception, and early pregnancy loss in polycystic ovary syndrome. BMJ. 1988; 297(6655):1024-6. PMC: 1834779. DOI: 10.1136/bmj.297.6655.1024. View

Damario M, Barmat L, Liu H, Davis O, Rosenwaks Z . Dual suppression with oral contraceptives and gonadotrophin releasing-hormone agonists improves in-vitro fertilization outcome in high responder patients. Hum Reprod. 1998; 12(11):2359-65. DOI: 10.1093/humrep/12.11.2359. View

Rebar R, Judd H, Yen S, RAKOFF J, Vandenberg G, Naftolin F . Characterization of the inappropriate gonadotropin secretion in polycystic ovary syndrome. J Clin Invest. 1976; 57(5):1320-9. PMC: 436785. DOI: 10.1172/JCI108400. View

10.

Oner G, Muderris I . Assessment of ovarian reserve based on hormonal parameters, ovarian volume, and antral follicle count in women with familial Mediterranean fever. Eur J Obstet Gynecol Reprod Biol. 2013; 170(2):449-51. DOI: 10.1016/j.ejogrb.2013.07.023. View

11.

Quatrini L, Ricci B, Ciancaglini C, Tumino N, Moretta L . Regulation of the Immune System Development by Glucocorticoids and Sex Hormones. Front Immunol. 2021; 12:672853. PMC: 8260976. DOI: 10.3389/fimmu.2021.672853. View

12.

Joham A, Norman R, Stener-Victorin E, Legro R, Franks S, Moran L . Polycystic ovary syndrome. Lancet Diabetes Endocrinol. 2022; 10(9):668-680. DOI: 10.1016/S2213-8587(22)00163-2. View

13.

Wang B, Li Z . Comparison of dual-trigger and human chorionic gonadotropin-only trigger among polycystic ovary syndrome couples who underwent controlled ovarian stimulation and intrauterine insemination: A retrospective cohort study. Medicine (Baltimore). 2023; 102(5):e32867. PMC: 9902005. DOI: 10.1097/MD.0000000000032867. View

14.

Kolibianakis E, Papanikolaou E, Camus M, Tournaye H, Van Steirteghem A, Devroey P . Effect of oral contraceptive pill pretreatment on ongoing pregnancy rates in patients stimulated with GnRH antagonists and recombinant FSH for IVF. A randomized controlled trial. Hum Reprod. 2005; 21(2):352-7. DOI: 10.1093/humrep/dei348. View

15.

Biljan M, Mahutte N, Dean N, Hemmings R, Bissonnette F, Tan S . Effects of pretreatment with an oral contraceptive on the time required to achieve pituitary suppression with gonadotropin-releasing hormone analogues and on subsequent implantation and pregnancy rates. Fertil Steril. 1998; 70(6):1063-9. DOI: 10.1016/s0015-0282(98)00333-1. View

16.

Weghofer A, Munne S, Brannath W, Chen S, Barad D, Cohen J . The impact of LH-containing gonadotropin stimulation on euploidy rates in preimplantation embryos: antagonist cycles. Fertil Steril. 2008; 92(3):937-942. DOI: 10.1016/j.fertnstert.2008.07.1735. View

17.

Tesarik J, Mendoza C . Effects of exogenous LH administration during ovarian stimulation of pituitary down-regulated young oocyte donors on oocyte yield and developmental competence. Hum Reprod. 2002; 17(12):3129-37. DOI: 10.1093/humrep/17.12.3129. View

18.

Seckin B, Yumusak O, Tokmak A . Comparison of two different starting doses of recombinant follicle stimulating hormone (rFSH) for intrauterine insemination (IUI) cycles in non-obese women with polycystic ovary syndrome (PCOS): a retrospective cohort study. J Obstet Gynaecol. 2021; 41(8):1234-1239. DOI: 10.1080/01443615.2020.1849069. View

19.

Deswal R, Nanda S, Dang A . Association of Luteinizing hormone and LH receptor gene polymorphism with susceptibility of Polycystic ovary syndrome. Syst Biol Reprod Med. 2019; 65(5):400-408. DOI: 10.1080/19396368.2019.1595217. View

20.

Coppola F, Poti E, Barusi L, Ferrari B, Salvarani M, Vadora E . Profound luteinizing hormone suppression induces a deleterious follicular environment during assisted reproduction technology. Fertil Steril. 2003; 79(2):459-60. DOI: 10.1016/s0015-0282(02)04671-x. View