Recombinant luteinizing hormone (rLH) and recombinant follicle stimulating hormone (rFSH) for ovarian stimulation in IVF/ICSI cycles

Mochtar, Monique H.; Danhof, N A; Ayeleke, Reuben Olugbenga; Veen, Fulco van der; Wely, Madelon van

doi:10.1002/14651858.cd005070.pub3

Cited by 69 publications

(68 citation statements)

References 59 publications

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“…[21,22]. The updated Cochrane review showed no clear evidence of a difference between rLH combined with rFSH and rFSH alone in live birth rates in spite of more ongoing pregnancies under LH supplementation, in which the benefits appeared to be more evident for low responders [23]. Hence, we don't propose the long-acting FSH plus MPA regimen in low responders.…”

Section: Resultsmentioning

confidence: 92%

Validation of an extremely patient-friendly progestin-primed ovarian stimulation protocol in normal and high responders by comparing with conventional antagonist protocol: a retrospective study

Huang

Chen

Shieh

et al. 2020

Preprint

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Background. Our previous study has shown a satisfactory reproductive outcome resulting from the extremely patient-friendly ovarian stimulation protocol of long-acting follicle stimulation hormone (FSH) plus oral medroxyprogesterone acetate (MPA). The present study was aimed to compare the efficacy of the extremely patient-friendly ovarian stimulation protocol with that of antagonist protocol.Methods. A retrospective study was conducted on normal and high responders aged from 24 to 39 years starting ovarian stimulation for IVF/ICSI with long-acting FSH at early follicular phase in a tertiary fertility center in Taiwan between December 2016 and August 2017. To prevent premature luteinizing hormone (LH) surge, oral MPA was applied in some cycles (group 1), whereas antagonist protocol was applied in other cycles (group 2). Freezing all embryos was applied to all patients in both groups. Duration of stimulation, number of shots and visits before trigger, incidence of premature LH surge, number of oocytes retrieved, fertilization rate, cleavage rate, rate of good embryos available, incidence of ovarian hyperstimulation syndrome, cumulative clinical pregnancy rate, and cumulative live birth rate per retrieval were compared between groups. Results. One hundred and ten cycles of IVF/ICSI were included, among which there were fifty-seven cycles in group 1 and fifty-three cycles in group 2. Starting with long-acting FSH, group 1 (MPA) required much fewer injections and visits but had comparable reproductive outcomes to those in group 2 (antagonist protocol).Conclusions. Long-acting FSH plus MPA use for ovarian stimulation is extremely friendly for the patients and demonstrates satisfactory stimulation and reproductive outcomes that are comparable to those of antagonist protocol.

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Section: Resultsmentioning

confidence: 92%

Validation of an extremely patient-friendly progestin-primed ovarian stimulation protocol in normal and high responders by comparing with conventional antagonist protocol: a retrospective study

Huang

Chen

Shieh

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…A large proportion of patients receiving ART treatment (43.3% in one study) would fulfill the criteria for suboptimal response or expected suboptimal response [23]. Based on recent meta-analyses, there is evidence that suboptimal responders and potentially other patient populations are likely to benefit from r-hLH supplementation [45][46][47][48][49] with respect to implantation, pregnancy, and live birth rates.…”

Section: Ovulatory Women (Including Women With Unexplained Infertilitmentioning

confidence: 99%

Decision points for individualized hormonal stimulation with recombinant gonadotropins for treatment of women with infertility

Lunenfeld

Bilger

Longobardi

et al. 2019

Gynecological Endocrinology

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It is essential that fertility treatment is individualized based on a thorough diagnostic work-up, with treatment tailored to the patients' requirements. This individualization should be kept in mind during the main decision points that occur before and during treatment. Treatment customization must include consideration of both the woman and her partner involved in the process together, including their collective treatment goals. Once treatment goals have been agreed and diagnostic evaluations performed, personalization based on patient characteristics, together with an understanding of treatment goals and patient preferences, enables the selection of appropriate treatments, protocols, products and their dosing. Following treatment initiation, monitoring and adaptation of product and dose can then ensure optimal outcomes. Currently, it is not possible to base treatment decisions on every characteristic of the patient and personalization is based on biomarkers that have been identified as the most relevant. However, in the future, the use of artificial intelligence coupled with continuous monitoring should enable greater individualization and improve outcomes. This review considers the current state-of-the-art related to decision points during individualized treatment of female infertility, before looking at future developments that might further assist in making individualized treatment decisions, including the use of computer-assisted decision making. ARTICLE HISTORY

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“…Taking LBR as a surrogate marker of embryo euploidy, in a Cochrane review of 36 RCTs (8125 women) there was insufficient evidence to determine whether there was a difference between rLH combined with rFSH vs rFSH alone in LBR (OR: 1.32, 95% CI: 0.85-2.06; n = 499; studies = 4; I 2 = 63%, very low-quality evidence) (Mochtar et al 2017). The most recent systematic review assessing the role of rLH supplementation in COS for ART in specific subgroups of patients was published by Alviggi et al (2018).…”

Section: Lh Supplementationmentioning

confidence: 99%

Ovarian stimulation for preimplantation genetic testing

Rodriguez-Purata

Martínez

2019

Reproduction

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A narrative review of the management of controlled ovarian stimulation in patients undergoing preimplantation genetic testing is presented. An electronic search was performed to identify research publications that addressed ovarian stimulation and preimplantation genetic testing published until December 2017. Studies were classified in decreasing categories: randomized controlled trials, prospective controlled trials, prospective non-controlled trials, retrospective studies and experimental studies. The aim of controlled ovarian stimulation has shifted from obtaining embryos available for transfer to yielding the maximum embryos available for biopsy to increase the odds of achieving one euploid embryo available for transfer, without the distress of inducing ovarian hyperstimulation syndrome or inadequate endometrium receptivity as vitrification and deferred embryo transfer usually will be planned. The present narrative review summarizes all treatment-related variables as well as stimulation strategies after controlled ovarian stimulation that could help patients undergoing an in vitro fertilization cycle coupled with preimplantation genetic testing, including the number of oocytes needed to achieve one healthy live birth, oral contraceptive pill usage, the role of mild ovarian stimulation or random-start stimulation, the stimulation protocol and type of gonadotropin of choice, the novel progesterone protocols, agonist or dual trigger as a final oocyte maturation trigger, the accumulation of oocytes/embryos and the optimal interval before proceeding with a subsequent controlled ovarian stimulation or the optimal medication to link stimulation cycles. The discussion is being presented according to how questions are posed in clinical practice. The aim of ovarian stimulation has shifted from obtaining embryos available for transfer to yielding the maximum embryos available for biopsy to increase the odds of achieving one euploid embryo available for transfer.

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Recombinant luteinizing hormone (rLH) and recombinant follicle stimulating hormone (rFSH) for ovarian stimulation in IVF/ICSI cycles

Abstract: Recombinant luteinizing hormone (rLH) and recombinant follicle stimulating hormone (rFSH) for ovarian stimulation in IVF/ICSI cycles.

Cited by 69 publications

References 59 publications

Validation of an extremely patient-friendly progestin-primed ovarian stimulation protocol in normal and high responders by comparing with conventional antagonist protocol: a retrospective study

Validation of an extremely patient-friendly progestin-primed ovarian stimulation protocol in normal and high responders by comparing with conventional antagonist protocol: a retrospective study

Decision points for individualized hormonal stimulation with recombinant gonadotropins for treatment of women with infertility

Ovarian stimulation for preimplantation genetic testing

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