Exogenous luteinizing hormone in controlled ovarian hyperstimulation for assisted reproduction techniques

Objective: To investigate the role of exogenous LH in controlled ovarian hyperstimulation for assisted reproductive technologies. Design: Prospective randomized study. Setting: SISMER fertility unit. Patient(s): Women showing a hyporesponsiveness to FSH under GnRH agoinst down-regulation were randomized into three groups: group A (n = 54) received an increased dosage of FSH; group B (n = 54) was administered recombinant LH in addition to the increased dose of FSH; group C (n = 22) was given additional FSH and LH using hMG as a combined drug. Fifty-four age-matched women with no need to increase the FSH dose were included as a control group (D). Intervention(s): None. Main Outcome Measure(s): Implantation and live birth rate per started cycles. Result(s): In group B, the pregnancy and implantation rates were statistically higher when compared with groups A and C and did not differ from the control group for normal response. The live birth rate was similar in groups B and D but was half as high in groups A and C. Conclusion(s): Hyporesponsiveness to FSH could be related to iatrogenic LH deficiency that, in turn, could affect oocyte competence. Addition of a small amount of recombinant LH is able to rescue oocyte competence to produce viable embryos. (C) 2004 by American Society for Reproductive Medicine.