Endocrine profile following stimulation with recombinant follicle stimulating hormone and luteinizing hormone versus highly purified human menopausal gonadotropin

Abstract

BackgroundLuteinizing hormone (LH) activity in human menopausal gonadotropin (hMG) preparations is derived from human chorionic gonadotropin (hCG) rather than LH. Therefore, we aimed to determine whether there are similarities in the endocrine and follicular profiles of serum and follicular fluid from controlled ovarian stimulation with the recombinant gonadotropins follicle-stimulating hormone plus luteinizing hormone (rFSH + rLH) or highly purified human menopausal gonadotropin (HP-hMG).MethodsWe performed a prospective observational study with 50 oocyte donors that received either a combination of recombinant gonadotropins (rFSH + rLH) or a mixture of urinary gonadotropins (HP-hMG) plus purified urinary FSH (uFSH). Results were analyzed using Student’s t-test to compare continuous variables and the chi-squared test to compare proportions. P-values < 0.05 were considered statistically significant.ResultsAlthough more oocytes were retrieved after treatment with recombinant than urinary gonadotropins (16.5 vs. 11.8; P = 0.049), a higher proportion of metaphase II ova (71.2% vs. 80.6%; P = 0.003) were obtained using urinary gonadotropins. On day 6 and on the day of triggering, serum steroid hormone levels were slightly but not significantly elevated in the recombinant group compared with the urinary group. In follicular fluid, no statistical differences were observed for intra-follicular levels of steroid hormones between the two protocols; ongoing pregnancy rates were similar (46.1% vs. 46.1%).ConclusionsOur data suggest that endocrinological and follicular profiles do not differ between rFSH + rLH and HP-hMG stimulation.

Progestin‐primed ovarian stimulation with or without clomiphene citrate supplementation in normal ovulatory women undergoing in vitro fertilization/intracytoplasmic sperm injection: A prospective randomized controlled trial

“…According to the “two‐cell, two‐gonadotropin” theory, LH might lead to the synthesis of progesterone and dehydroepiandrosterone sulphate, which are precursors of oestrogen, thus leading to a negative feedback regulation of LH level. Although study on hMG vs recombinant FSH + recombinant LH demonstrated similar hormone profiles for both groups, small variations in steroid hormones are difficult to capture using blood samples. Moreover, the pregnancy rate in this study was higher than the rates in other studies, as most of the participants were young and nearly 80% of these women had not experienced IVF failure.…”

Comparison of FSH and hMG on ovarian stimulation outcome with a GnRH antagonist protocol in younger and advanced reproductive age women

“…Therefore, quantifying the precise biological activity of gonadotropins was difficult. However, Requena [16] reported that endocrine and follicular profiles were not different between rFSH + rLH and hp-hMG stimulation and previous studies also compared hMG with uFSH [5, 11, 14, 16]. …”

Bio-equivalent doses of recombinant HCG and recombinant LH during ovarian stimulation result in similar oestradiol output: a randomized controlled study

“…It seems, however, that a daily bolus of rLH is still sufficient, despite its short half-life, to boost steroidogenesis and, in particular, oestradiol to levels similar to those induced by a daily bolus of rHCG. Over the years, studies have compared different low-dose HCG or rLH supplementation regimens with FSH stimulation (Drakakis et al, 2009;Kilani et al, 2003;Requena et al, 2014;Thuesen et al, 2012;Van Horne et al, 2007). Therefore, Van Horne et al (2007) retrospectively analysed the outcomes of 190 cycles in which either rFSH alone or rFSH supplemented with uHCG (50-100 IU) daily were used for ovarian stimulation.…”

“…The investigators reported that the number of follicles, oocytes and transferable embryos as well as the clinical pregnancy rate were significantly higher in the HCG group. In a more recent study, Requena et al (2014) compared the steroid profile after stimulation with rFSH and rLH versus HMG in 50 oocyte donors. Both groups had a FSH:LH activity ratio of 2:1 and the LH bioactivity ratio was 1:1.…”