Effect of mid-follicular phase recombinant LH versus urinary HCG supplementation in poor ovarian responders undergoing IVF – a prospective double-blinded randomized study

Mak, Jennifer Sze Man; Wong, Wai Yee; Chung, Hoi Sze; Chung, Pui Wah; Kong, Grace; Li, Tin‐Chiu; Cheung, Lai Ping

doi:10.1016/j.rbmo.2016.11.014

Cited by 23 publications

(8 citation statements)

References 39 publications

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“…Midfollicular recombinant luteinizing hormone (rLH) or urinary human chorionic gonadotrophin (HCG) supplementation is another experimental modification applied to improve retrieved oocytes in POR cases during antagonist cycles [29].…”

Section: Stimulation Modificationsmentioning

confidence: 99%

Ovarian stimulation modalities in poor responders

Özkan

2019

Turk J Med Sci

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In a group of IVF/ICSI cycles, despite the appropriate ovarian stimulation, the number of oocytes collected is below the expected value. This condition is defined as poor ovarian response (POR) to stimulation. POR brings the risk of cycle cancellation with an estimated rate of 20%. Infertility experts are trying to improve cycle outcomes of POR cases with multiple modifications. This review article will present the latest modifications on the management of POR. The studies performed for improving cycle outcome in POR cases were evaluated and their notable results were presented. The first intervention among infertility specialists is to make a standard definition for POR. The BOLOGNA criteria and the subsequent POSEIDON group definitions are the latest updates in POR management. GnRH antagonists, estradiol priming, double stimulation, letrozole administration, DHEA, and herbal therapy supplementations are the recent modifications done to improve oocyte retrieval and subsequent embryo transfer for POR cases. This review article presents the encouraging methods applied for POR cases to improve cycle outcome.

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Section: Stimulation Modificationsmentioning

confidence: 99%

Ovarian stimulation modalities in poor responders

Özkan

2019

Turk J Med Sci

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“…It assures adequate LH receptoral response in the granulosa cells [2]. After hCG became the substitute in this phase, its role was extended to the follicular phase [6], where the long-standing debate on the role of LH/hCG has not yet been resolved [6,7,8]. …”

Section: Introductionmentioning

confidence: 99%

hCG Triggering in ART: An Evolutionary Concept

Klement

Shulman

2017

IJMS

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Human chorionic gonadotropin (hCG) is no longer a single, omnipotent ovulation triggering option. Gonadotropin releasing hormone (GnRH) agonist, initially presented as a substitute for hCG, has led to a new era of administering GnRH agonist followed by hCG triggering. According to this new concept, GnRH agonist enables successful ovum maturation, while hCG supports the luteal phase and pregnancy until placental shift.

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“…Previous studies comparing r-hFSH+hMG and r-hFSH+r-hLH were mainly conducted on Western populations, and most of them applied GnRH-agonist protocol for pituitary gland downregulation ( 14 – 16 ). There have been few studies in Asian countries, and the design of their research groups differs from the present study ( 24 , 25 ).…”

Section: Discussionmentioning

confidence: 85%

A retrospective, matched case-control study of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol

Chen

Yi²,

Guu³

et al. 2022

Front. Endocrinol.

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BackgroundThe role of luteinizing hormone (LH) in controlled ovarian hyperstimulation (COH) requires more evidence for its efficacy. Several studies compared recombinant human LH (r-hLH) or human menopausal gonadotropin (hMG) in combination with recombinant human follicle-stimulating hormone (r-hFSH) but lack the results with GnRH-antagonist protocol and in Asians.MethodsThis is a retrospective, single-center study inspecting women receiving GnRH antagonist protocol and r-hFSH+hMG or r-hFSH+r-hLH regimen for over five days for COH in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle in Taiwan from 2013 to 2018. The outcomes of IVF/ICSI cycles were analyzed after propensity score matching between the two groups. A subgroup analysis was conducted in cycles in which women underwent their first embryo transfer (ET), including fresh ET and frozen ET (FET).ResultsWith a total of 503 cycles, the results revealed that the r-hFSH+r-hLH group performed better in terms of numbers of oocytes retrieved (r-hFSH+hMG vs. r-hFSH+r-hLH, 11.7 vs. 13.7, p=0.014), mature oocytes (8.7 vs. 10.9, p=0.001), and fertilized oocytes (8.3 vs. 9.8, p=0.022), while other outcomes were comparable. The analysis of first ET cycles also showed similar trends. Although the implantation rate (39% vs. 43%, p=0.37), pregnancy rate (52% vs. 53%, p=0.90), and live birth rate (39% vs. 45%, p=0.19) were not significantly different, the miscarriage rate was higher in the r-hFSH+hMG group than the r-hFSH+r-hLH group (26% vs. 15%, p<0.05) in first ET cycles. The cumulative pregnancy rate was significantly higher in the r-hFSH+r-hLH group (53% vs. 64%, p=0.02). No significant difference in rates of ovarian hyperstimulation syndrome (OHSS) was observed.ConclusionThe results support the hypothesis that the treatment of r-hLH+r-hFSH improves COH clinical outcomes in the IVF/ICSI cycle.

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Effect of mid-follicular phase recombinant LH versus urinary HCG supplementation in poor ovarian responders undergoing IVF – a prospective double-blinded randomized study

Cited by 23 publications

References 39 publications

Ovarian stimulation modalities in poor responders

Ovarian stimulation modalities in poor responders

hCG Triggering in ART: An Evolutionary Concept

A retrospective, matched case-control study of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol

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