Clinical effects of ovulation induction with recombinant follicle-stimulating hormone supplemented with recombinant luteinizing hormone or low-dose recombinant human chorionic gonadotropin in the midfollicular phase in microdose cycles in poor responders

Efficacy of low dose hCG on oocyte maturity for ovarian stimulation in poor responder women undergoing intracytoplasmic sperm injection cycle: a randomized controlled trial

“…An earlier study found no significant greater number of mature oocytes in patients treated with only rFSH compared to the women who received LH activity in the form of LH or hCG supplementation [22]. This trend was inversely detected by our study which higher number of mature oocytes was seen in poor responders who received 100 or 200 IU hCG compared to the rFSH only group, although the differences among the groups were not statistically significant.…”

“…A comparable trend which didn't achieve statistical significance, was also noted in a similar trial in poor responders [22]. Some other previous studies reported a significant decrease in total dosage and duration of rFSH treatment in administration of rFSH supplemented or substituted by low dose hCG in a GnRH antagonist protocol [18,19,35,47].…”

“…Some studies noted [22,23] that exogenous LH/hCG administration has no further benefit in poor responders to ovarian stimulation. However, several other studies have shown better outcomes with additional LH in poor responders when GnRH-a short or long protocols were applied [40][41][42] whereas in the study of Bjercke et al and Hompes et al [43,44] in normal responders, the clinical outcomes were similar between rFSH and hMG groups.…”

“…Thereafter, many researchers noted that adding LH activity, through administration of low-dose hCG in the late follicular phase resulted in follicles development and oocytes maturation, avoidance of premature luteinization, improved clinical pregnancies, lowering the rFSH requirements and reducing COH costs [18][19][20][21]. Conversely, some other authors failed to confirm these findings [22][23][24][25].…”

The Use of rLH, HMG and hCG in Controlled Ovarian Stimulation for Assisted Reproductive Technologies

“…While this protocol represents a well-established approach to increasing endogenous LH and FSH, randomized controlled trials have been small and inconclusive on whether this protocol increases live birth rates (113)(114)(115)(116). One RCT did not show any benefit to adding either rLH or low-dose rHCG to a microdose flare protocol for poor responders (117). A Cochrane review has suggested that poor responders may benefit from the addition of rLH (98).…”