Objective To compare the in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle outcomes between patients with low and normal serum luteinizing hormone (LH) levels on the day after a gonadotropin-releasing hormone agonist (GnRH-a) single trigger. We further investigated the efficacy of human chorionic gonadotropin (hCG) retrigger on IVF cycle outcomes in patients with low LH levels after GnRH-a single trigger. Methods We retrospectively analyzed 957 infertile patients (tubal factor, ovulation disorders, male sperm factor, or unexplained infertility) who were treated with IVF/ICSI at the Chengdu Xinan Gynecology Hospital from July 2017 to December 2020. Patients received sufficient GnRH-a single trigger were divided into two groups based on the serum LH levels on the next day of trigger: normal serum LH levels (≥ 10 mIU/mL) group (control group, n = 906) and low LH levels (< 10 mIU/mL) group (experimental group, n = 51). And the efficacy of hCG retrigger on IVF/ICSI cycle outcomes in 10 patients with low LH levels after GnRH-a single trigger. Results There were no significant differences in IVF/ICSI cycle outcomes, including egg yield, two pronuclei fertilization rate, excellent embryo rate, or live birth rate of frozen-thawed embryos between patients with low and normal LH levels after GnRH-a trigger. It showed significantly higher risk of ovarian hyperstimulation syndrome in the group of low LH levels [ 0.7%(1/137) vs. 8.5%(4/47), P = 0.016] compared with the group of normal LH levels who received GnRH-a single trigger. The hCG retrigger had no obvious efficacy on cycle outcomes in patients with low LH levels, including oocytes retrieved, fertilization rate, embryo conditions, and live birth rate of frozen-thawed cycles. Conclusion The IVF/ICSI cycle outcomes of patients with low LH levels on the day after GnRH-a administration were similar to those of patients with normal LH levels. Blood LH test might not be required on the day following the trigger. The hCG retrigger did not have any effect on the cycle outcomes, suggesting that immediate retriggering with hCG was unnecessary.
Objective: To compare the embryo condition and clinical outcomes between patients with low and normal serum luteinizing hormone (LH) levels on the day after a single trigger of gonadotropin-releasing hormone agonist (GnRH-a). In patients with low LH levels we further analyzed the efficacy of human chorionic gonadotropin (HCG) to trigger ovulation.Methods: We retrospectively analyzed 957 infertile patients (tubal factor, ovulation disorders, male sperm factor, or unexplained infertility) who were treated with in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI)-assisted pregnancy at the Chengdu Xinan Gynecology Hospital from July 2017 to December 2020. Patients with sufficient GnRH-a single trigger and normal serum LH levels on the next day were used as the control group (n=906), and patients with low LH levels were set as the experimental group (n=51), of whom 10 received HCG retriggering. We analyzed the effects of low and normal LH levels, and the efficacy HCG retriggering in patients with low LH level on the embryo status and embryonic transplantation after cryopreservation outcome of patients. Results: There were no significant differences in egg yield, 2PN fertilization rate, excellent embryo rate, or live birth rate of frozen-thawed embryos between patients with low and normal LH levels after GnRH-a trigger. There was also no difference in patients with low LH levels who received HCG retriggering or not.Conclusion: The outcomes of patients with low LH levels on the day after GnRH-a administration were similar to those of patients with normal LH levels. The embryo status and live birth rate of frozen-thawed embryos in patients with low LH levels in the HCG retriggering and non-HCG retriggering groups are similar. When blood LH< 10 miu/ml was measured on the day after GnRH-a trigger, no special treatment was required, and there was no significant effect on embryonic and clinical outcomes. No blood LH test is required on the day following the trigger, which does not affect the outcome of in vitro fertilization.
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