The impact of luteinizing hormone supplementation in gonadotropin-releasing hormone antagonist cycles: a retrospective cohort study

Abstract

The impact of exogenous luteinizing hormone (LH) supplementation to patients undergoing controlled ovarian stimulation with gonadotropin-releasing hormone (GnRH) antagonists on cycle outcomes is controversial. Here, we present a retrospective cohort study including cycles from December 2015 to December 2016. Totally 320 cycles were divided into two groups according to with or without exogenous LH supplementation. No significant differences regarding the number of retrieved oocytes, the number of good-quality embryos, and clinical pregnancy rate between the two groups were found. The logistic regression analysis revealed that LH supplementation was not independently associated with clinical pregnancy rate (OR = 0.577, 95% CI: 0.272–1.222, p = .58) or a biochemical pregnancy rate (OR = 0.922, 95% CI: 0.444–1.916, p = .83). When patients were divided into subgroups based on age, more retrieved oocytes (5.60 vs. 3.97, p = .04) and good-quality embryos (3.07 vs. 1.93, p = .01) were achieved in cycles with exogenous LH supplementation for 40 years and over group. We conclude that for aged women (40 years old and over), LH supplementation has a positive impact on the number of retrieved oocytes and good-quality embryos in GnRH antagonist cycles.

Chinese abstract

通过促性腺激素释放激素（GnRH）拮抗剂控制卵巢刺激的患者补充外源性黄体生成素（LH）对周期结局的影响是有争议的。在此, 我们进行了一个包括从2015年12月至2016年12月周期的回顾性队列研究。根据是否补充外源性LH, 将320个周期分为两组。两组之间获卵数、优质胚胎数及临床妊娠率无显著性差异。Logistic回归分析显示, LH补充与临床妊娠率(OR =0.577, 95% CI: 0.272–1.222, p=.58)和生化妊娠率(OR =0.922, 95% CI: 0.444–1.916, p=.83)无关。将患者按年龄分组, ≥40岁组在外源性LH补充周期中取得更多的获卵数(5.60 vs. 3.97, p=.04)和优质胚胎率(3.07 vs. 1.93, p=.01)。我们认为, 对高龄妇女（≥40岁）来说, LH补充对GnRH拮抗剂周期中获卵数和优质胚胎率具有积极的影响。

Keywords:

• Luteinizing hormone
• in vitro fertilization and embryo transfer
• gonadotropin releasing hormone antagonist protocol
• pregnancy outcomes

Acknowledgements

We would like to thank Wei Lin, M.D. (Dermatology Hospital of Southern Medical University) for statistical analysis instruction and also the staff and patients of Center for Reproductive Medicine, the Third Affiliated Hospital, Sun Yat-sen University.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Department of Science and Technology of Guangdong province [2014A070711008].