Effect of Exogenous Luteinizing Hormone (LH) Supplementation on Clinical Pregnancy of Patients Receiving Long-Acting Gonadotropin-Releasing Hormone Agonist (GnRHa) Cycles: A Retrospective Cohort Study

Abstract

Purpose Timely and moderate luteinizing hormone (LH) secretion plays critical roles in follicle development and maturation. However, the role of LH supplementation in in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) cycles remains unclear. Can LH supplementation improve the clinical outcomes of patients who receive long-acting gonadotropin-releasing hormone agonist (GnRHa) pituitary downregulation in IVF/ICSI-ET cycles? Patients and Methods This is a retrospective cohort study of 2600 long-acting GnRHa down-regulated IVF/ICSI cycles from 2017 to 2020 in our reproductive medicine centre of Nanjing Drum Tower Hospital. Total cycles were divided into two groups according to LH supplementation or not. In addition, we conducted a secondary analysis that used propensity-score matching to reduce the effects of confounding. Results Exogenous LH addition was not significantly correlated with the clinical pregnancy rate (OR=0.910, 95% CI: 0.623–1.311, p=0.61) in logistic regression analysis. After propensity-score matching, we also found no significant association between LH supplementation and the clinical pregnancy rate (OR=0.792, 95% CI: 0.527–1.191, p=0.26). Conclusion There is no obvious effect of exogenous LH supplementation on the clinical pregnancy rate in non-selective patients receiving long-acting GnRHa IVF/ICSI-ET cycles, which suggests that exogenous LH addition is not always needed, which can help us avoid drug overuse to a certain extent.

The relationship between duration of infertility and clinical outcomes of intrauterine insemination for younger women: a retrospective clinical study

“…A univariate analysis was employed to identify potential influencing factors of clinical pregnancy outcomes in IUI cycles. And then a multivariable logistic-regression model was conducted for further analysis including the identified factors [ 18 ]. In addition, the propensity-score method was used to reduce the effects of confounding.…”

“…In addition, the propensity-score method was used to reduce the effects of confounding. Matching was performed with the use of a 1:1 matching protocol without replacement, with a caliper width equal to 0.01 of the standard deviation of the logit of the propensity score [ 18 ]. Furthermore, subgroup analysis based on age stratification was conducted to elucidate the impact of different infertility duration on clinical pregnancy outcomes.…”