Exogenous hCG activity, but not endogenous LH activity, is positively associated with live birth rates in anovulatory infertility

Abstract

Objective. To evaluate, retrospectively, the roles of endogenous and exogenous luteinising hormone (LH) activity on live birth rate in ovulation induction cycles.

Methods. Associations between LH activity at baseline, end of stimulation and live birth rate were analysed in relation to patient characteristics, baseline and end of stimulation variables in WHO group II anovulatory women (n = 155) stimulated with recombinant follicle-stimulating hormone (rFSH) or highly purified human menopausal gonadotrophin (HP-hMG). HP-hMG provides FSH and exogenous LH activity mainly in the form of human chorionic gonadotrophin (hCG).

Results. Serum LH concentrations at baseline or end of stimulation were not predictive of live birth rate in the rFSH group (n = 79) or HP-hMG group (n = 76). Serum hCG concentration at end of stimulation was a significant positive predictor in HP-hMG-treated women. Other variables were not independently predictive of live birth in either of the groups, except for a negative association between serum FSH concentrations at the start of stimulation and live birth in the rFSH-treated group.

Conclusions. Endogenous LH concentrations are not predictive of live birth in anovulatory WHO group II patients undergoing ovulation induction with rFSH or HP-hMG. On the other hand, exogenous hCG activity during HP-hMG stimulation is positively associated with treatment outcome.

Keywords::

• Highly purified menotrophin
• human chorionic gonadotrophin
• infertility
• live birth
• luteinising hormone
• ovulation induction

Acknowledgements

The study was sponsored by Ferring Pharmaceuticals A/S, Copenhagen, Denmark. The authors thank Klaus Juel Olsen, PhD, Larix Aps, Denmark, for statistical assistance, and Göran Pettersson, PhD, Ferring Pharmaceuticals A/S, Copenhagen, Denmark for support with the preparation of this manuscript. We also thank all the centres from which the study cohort was derived: Belgium: Virga Jesse Ziekenhuis, Hasselt; AZ-VUB, Brussels; AZ Groeninge, Kortrijk; Hôpital Saint Vincent, Rocourt; Hôpital Erasme, Brussels; Centre Hospitalier Notre Dame, Charleroi; AZ St. Lucas, Gent; Universitair Ziekenhuis, Gent. United Kingdom: Leeds Hospital; Ninewells Hospital, Dundee; Glasgow Royal Infirmary; The Jessop Wing, Sheffield; Liverpool Women's Hospital; Princess Anne Hospital, Southampton; Guy's Hospital, London. Sweden: Uppsala University Hospital; Sahlgrenska University Hospital, Gothenburg; Lund University Hospital; Karlstad Hospital; Helsingborg Hospital. Denmark: Copenhagen University Hospital; Brædstup Hospital; Hvidovre Hospital; Randers Hospital; Skive Hospital; Holbæk Hospital; Herlev Hospital; Odense University Hospital; Skejby Hospital.

Declaration of interest: Joan-Carles Arce is employee of Ferring Pharmaceuticals. Johan Smitz has nothing to disclose.