Gynecology & Obstetrics
Open Access

Effects of exogenous luteinizing hormone on patients with relative LH defi ciency after pituitary down-regulation during controlled ovarian hyperstimulation

International Conference on Pediatrics & Gynecology

6-8 December 2011 Philadelphia Airport Marriott, USA

Zhihong Niu, Yun Feng, Aijun Zhang, Yijuan Sun and Xiaowei Lu

Accepted Abstracts: Pediatr Therapeut

Abstract :

Background: Th e eff ect of exogenous LH supplementation on ovarian stimulation parameters, as well as treatment outcome was evaluated in patients with relative LH defi ciency (serum FSH/LH ration≥3 on stimulation day 1 aft er pituitary downregulation with a GnRH agonist) and ovarian stimulation with recombinant FSH (rFSH) during IVF/ICSI cycles. Methods: Th e patients with serum FSH/LH ration≥3 on stimulation day 1 aft er pituitary down-regulation with a GnRH agonist were randomly divided into two groups: group 1, using f-FSH alone and no hMG addition through the stimulation procedures (n=143) and group 2, receiving human menopause gonadotropin (hMG) supplementation from the 7th day of stimulation (n=142). Treatment outcomes and relative hormone levels in both groups were compared. Results: Th ere ware no statistic diff erence on serum FSH, LH, E2 and progesterone level between two groups on baseline, stimulation day 1 and day 7. Patients in group 2, despite with fewer days of stimulation (9.6�0.8 vs. 9.9�1.1 P =0.009) and administering fewer amounts of total gonadotropin than group1 (30.6 � 4.5 vs. 33 � 4.1, P 0.001), have higher serum E2 concentration on HCG day compared to group 1(2615�1196 versus 2248�1028pg/ml, P =0.006). Th e two groups gained almost the similar number of oocytes but group 2 gained higher number of viable embryos (4.3�1.4 versus 3.8�1.5, P=0.004). Further, compared to group1, group 2 had higher proportion of patients with serum E2 reaching 3000-4000pg/ml (30.8% versus 18.5%, P<0.05) and higher number of follicle with average diameter in range of 10-14 mm on hCG day (7.5�1.8 versus 6.3�2.0, P<0.05). No signifi cant diff erences ware found for other variables such as number of embryo transferred and pregnancy outcomes. Conclusions: In stimulation protocol with pituitary down-regulation by a GnRH agnist, exogenous LH addition by hMG from stimulation day 7 could increase ovarian response and improve embryo quality for patients with FSH/LH ≥3 on the fi rst day of ovarian stimulation.