Differences in serum LH and FSH levels using depot or daily GnRH agonists in controlled ovarian stimulation: influence on ovarian response and outcome of ART

Abstract

Patients with profound endogenous LH suppression by depot GnRH agonists show higher FSH stimulation dose requirements and lower oocyte number and fertilization rate, indicating a need for minimal LH activity in folliculogenesis and oocyte development.

rLH/rFSH Combination Improved Cumulative Live Birth Rate in Patients With LH Over-Suppression Following GnRH Agonist Pituitary Down-Regulation Compared to rFSH or hMG Alone: A Retrospective Cohort Study With Propensity Score Matching

“…Similar results have been reported elsewhere [16][17][18]. Sonntag et al report that long-term use of GnRH-a can lead to low levels of endogenous LH [19], thus it is important to supplement exogenous LH in patients with low LH levels [20]. Previous studies also found that patients with low serum LH levels achieved better clinical pregnancy rates after adding exogenous LH [15,[21][22][23][24].…”

Profile of follitropin alpha/lutropin alpha combination for the stimulation of follicular development in women with severe luteinizing hormone and follicle-stimulating hormone deficiency

“… 82 The degree of pituitary suppression depends also on the GnRH-a formulation as well as the mode and dose of administration. 83 , 84 …”

“… 84 , 85 Some authors attributed this phenomenon to the profound suppression of LH level after long downregulation GnRH-a protocol. 83 , 84 Several studies have been conducted with the aim of establishing a valuable cutoff of circulating LH level after pituitary desensitization in order to identify those patients, but the results obtained are conflicting. 84 , 85 Conversely, a meta-analysis published by Kolibianakis et al 86 showed no evidence that low endogenous LH levels, which may occur during long protocols of ovarian stimulation for in vitro fertilization, require exogenous LH supplementation to improve the probability of ongoing pregnancy.…”

Live Birth Outcomes for PCOS Patients Under Depot Agonist Protocol or Antagonist Protocol - a retrospective Chinese cohort

“…Prominent protocols for PCOS include the gonadotropin-releasing hormone agonist (GnRHa) long protocol and the GnRH antagonist protocol [12]. Two types of GnRHa pattern can be used to prevent premature luteinization: a low (0.1 mg) daily dose of GnRHa or a separate, higher dose (3.75 mg) of long-acting GnRHa analogue, which is also called depot GnRHa [17][18][19]. The depot GnRH agonist protocol is preferred for its convenient single-injection delivery and satisfactory pregnancy rates [20,21].…”