Role of Lh polymorphisms and r-hLh supplementation in GnRh agonist treated ART cycles: A cross sectional study

Raju, Gottumukkala Achyuta Rama; Cheemakurthi, Ravikrishna; Prathigudupu, Kavitha; Balabomma, Kavitha Lakshmi; Madan, K.; Thota, Sivanarayana; Krishna, Kota Murali

doi:10.1016/j.ejogrb.2018.01.025

Cited by 15 publications

(9 citation statements)

References 23 publications

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“…It is, therefore, biologically plausible that LH supplementation in women with genetic polymorphisms involving gonadotropins and their receptors might overcome the genetically determined ovarian resistance to gonadotropin stimulation. In line with this hypothesis, Ramaraju et al observed that both women heterozygous or homozygous for the G allele required higher doses of rLH supplementation during OS than those without these genetic traits; in their study, the use of rLH supplementation resulted in increased clinical pregnancy rates [57]. The added LH during stimulation acts on theca cells and increases androgen synthesis, which in turn improve FSH receptor sensitivity during COS [58–60].…”

Section: Discussionmentioning

confidence: 99%

The role of recombinant LH in women with hypo-response to controlled ovarian stimulation: a systematic review and meta-analysis

Conforti

Esteves²,

Rella

et al. 2019

Reprod Biol Endocrinol

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ObjectiveTo study the role of recombinant human LH supplementation in women with hypo-response to ovarian stimulation.MethodsWe performed a systematic review and meta-analysis of prospective clinical trials in which recombinant FSH monotherapy protocols were compared with LH-supplemented protocols in hypo-responders. A search was conducted of the Scopus, MEDLINE databases without time or language restrictions. Primary outcome was clinical pregnancy rate.ResultsSignificantly higher clinical pregnancy rates (odds ratio: 2.03, P = 0.003), implantation rates (odds ratio: 2.62, P = 0.004) and number of oocytes retrieved (weight mean differences: 1.98, P = 0.03) were observed in hypo-responders supplemented with recombinant LH versus hypo-responders who underwent FSH monotherapy. No differences in terms of mature oocytes or miscarriage rates were found between the two groups.ConclusionIn conclusion, our analysis confirms that women with a hypo-response to exogenous gonadotropins might benefit from LH supplementation. However, more trials are required before a definitive conclusion can be drawn.Electronic supplementary materialThe online version of this article (10.1186/s12958-019-0460-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The role of recombinant LH in women with hypo-response to controlled ovarian stimulation: a systematic review and meta-analysis

Conforti

Esteves²,

Rella

et al. 2019

Reprod Biol Endocrinol

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“…Thus, polymorphisms of the LH beta chain and of LHCGRs could reduce ovarian sensitivity to FSH, which suggests that the function of both gonadotropins is crucial during OS. In addition, the presence of serine instead of asparagine in Position 312 might lead to reduced sensitivity to LH action and may explain why carriers of this polymorphism required more r-hLH during OS than non-carriers ( Ramaraju et al , 2018 ). Moreover, in the same study, the pregnancy rate was significantly higher in serine carriers who received r-hFSH:r-hLH than in those receiving r-hFSH alone ( P = 0.04) ( Ramaraju et al , 2018 ).…”

Section: Lh and Fsh Deficiency In Medically Assisted Reproductionmentioning

confidence: 99%

Reduced FSH and LH action: implications for medically assisted reproduction

et al. 2021

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Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) play complementary roles in follicle development and ovulation via a complex interaction in the hypothalamus, anterior pituitary gland, reproductive organs, and oocytes. Impairment of the production or action of gonadotropins causes relative or absolute LH and FSH deficiency that compromises gametogenesis and gonadal steroid production, thereby reducing fertility. In women, LH and FSH deficiency is a spectrum of conditions with different functional or organic causes that are characterized by low or normal gonadotropin levels and low oestradiol levels. While the causes and effects of reduced LH and FSH production are very well known, the notion of reduced action has received less attention by researchers. Recent evidence shows that molecular characteristics, signalling as well as ageing, and some polymorphisms negatively affect gonadotropin action. These findings have important clinical implications, in particular for medically assisted reproduction in which diminished action determined by the afore-mentioned factors, combined with reduced endogenous gonadotropin production caused by GnRH analogue protocols, may lead to resistance to gonadotropins and, thus, to an unexpected hypo-response to ovarian stimulation. Indeed, the importance of LH and FSH action has been highlighted by the International Committee for Monitoring Assisted Reproduction Technologies (ICMART) in their definition of hypogonadotropic hypogonadism as gonadal failure associated with reduced gametogenesis and gonadal steroid production due to reduced gonadotropin production or action. The aim of this review is to provide an overview of determinants of reduced FSH and LH action that are associated with a reduced response to ovarian stimulation.

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“…The genetic assessment of polymorphisms in the LHCGR gene for A/A, A/G, and G/G variants was performed as previously described (19).…”

Section: Genotypingmentioning

confidence: 99%

“…Eggs were retrieved after 34-38 hours following hCG administration through ultrasound guidance under conscious sedation. Collected oocytes were graded and fertilized with individual sperm using the intra-cytoplasmic sperm injection (ICSI) method followed by embryo culture as described earlier (19). The fertilization of oocytes was confirmed by the formation of pronuclei after 18 hours of ICSI.…”

Section: Egg Collection Fertilization and Embryo Transfermentioning

confidence: 99%

“…No significant difference was observed in FSH consumption, the mean number of oocytes or mature oocytes retrieved among the patients with different LHCGR (rs2293275) genotypes. However, a significant difference was observed in the live birth rates among the different LHCGR genotypes (18,19). Few studies demonstrated that the presence of asparagine at 312 position in LHCGR may render the receptor more sensitive (20,21).…”

Section: Introductionmentioning

confidence: 99%

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Effect of LHCGR Gene Polymorphism (rs2293275) on LH Supplementation Protocol Outcomes in Second IVF Cycles: A Retrospective Study

Cheemakurthi²,

Madan³

et al. 2021

Front. Endocrinol.

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Infertility is a major concern for couples wanting to have progeny. Despite recent advances in the field of IVF, success rates still need improvement. Understanding the patient’s variability and addressing it with personalized interventions may improve the success rate of fertilization and live births. This study examined the impact of a personalized pharmacogenomic approach on LH supplementation on the pregnancy and live birth rate outcomes in comparison with the traditional approaches. 193 patients undergoing a second IVF cycle in Krishna IVF Clinic received LH supplementation either as per the conventional methods or based on N312S (rs2293275) LHCGR gene polymorphism. Results showed a significant increase in pregnancy rate (P-value: 0.049) and a trend showing improvement in live birth rates (P-value: 0.082) when r-hLH supplementation protocol was decided as per the genotypes A/A, A/G, and G/G of the N312S variant in the respective patients. This stimulation regimen helped in providing optimum levels of r-hLH supplementation to patients with impaired hormone-receptor interacting activity, to achieve higher success in pregnancy and live birth rates.

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Role of Lh polymorphisms and r-hLh supplementation in GnRh agonist treated ART cycles: A cross sectional study

Cited by 15 publications

References 23 publications

The role of recombinant LH in women with hypo-response to controlled ovarian stimulation: a systematic review and meta-analysis

The role of recombinant LH in women with hypo-response to controlled ovarian stimulation: a systematic review and meta-analysis

Reduced FSH and LH action: implications for medically assisted reproduction

Effect of LHCGR Gene Polymorphism (rs2293275) on LH Supplementation Protocol Outcomes in Second IVF Cycles: A Retrospective Study

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