Effects of adding luteinizing hormone activity to gonadotropin releasing hormone antagonist protocols may differ according to age

Abstract

Objective. In spite of previous reports on the beneficial effects of adding exogenous luteinizing hormone (LH) activity to gonadotropin releasing hormone (GnRH) antagonist protocols for conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), these effects in various age groups are still controversial. This study was performed to evaluate the clinical efficacy of adding LH activity to GnRH antagonist protocols according to patient's age.

Methods. In this medical record review, responses to controlled ovarian hyperstimulation (COH) and IVF/ICSI outcomes were compared between follicle stimulating hormone (FSH) alone and FSH supplemented with LH activity groups in women ≤35 years (n = 135) and those >35 years (n = 97), respectively.

Results. Estradiol level on hCG day in LH-added group was higher (2.150.6 ± 1.345.1 pg/ml vs. 1.606.2 ± 994.6 pg/ml, P = 0.011) in women ≤35 years, while it did not differ in those >35 years. Less oocytes were retrieved in LH-added group of women >35 years (8.1 ± 6.5 vs. 5.7 ± 3.0, P = 0.013), however, this figure did not differ in those ≤35 years. Regardless of age, the clinical pregnancy rates were not different between the two groups.

Conclusions. Supplementation of exogenous LH activity to GnRH antagonist protocols affects the COH outcomes. These LH-adding effects may vary according to patient's age.

Keywords:

• LH
• GnRH antagonist
• IVF
• ICSI

Acknowledgements

This study was supported by a grant of the Korea Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (01-PJ10-PG6-01GN13-0002). The authors express their deepest gratitude to Sun Kyung Oh, Hee Sun Kim, Moon Ju Kang, Sung Ah Kim and Jun Ho Ku for their laboratory and statistical support of this study.