Low LH level does not indicate poor IVF cycle outcomes with GnRh-a single trigger: a retrospective analysis

Li, Xuefei; Wang, Qiao-Feng; He, Qi-Qi; Wang, Xuejiao; LV, Xing-Yu; Tang, Xiaojun; Zhong, Zhaohui; Ding, Yu-Bin; Wan, Qi

doi:10.1186/s12884-022-05251-4

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…This was in line with some previous studies in which the researchers believed that low serum LH level and low serum E2 level on the day of HCG administration led to low clinical pregnancy rates 11 – 13 . However, other studies hold a different view concluding that there was insufficient evidence to support or deny the presence of the association 14 , 15 . It 's very interesting that we found that patients who conceived at last had lower levels of E2 and LH in the first cycle.…”

Section: Discussionmentioning

confidence: 99%

Live birth rate following a failed first in vitro fertilization cycle with no embryos for transfer

Xiang

Xue

2023

Sci Rep

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After a failed in vitro fertilization (IVF) procedure in which no transferable embryo was obtained, the possibility of a subsequent pregnancy for the patient is unknown. We conducted a cohort retrospective study evaluating the live birth rate in the subsequent cycles of the patients with no embryo for transfer in their first IVF attempt between 2017and 2020. The first cycle variables of patients who conceived in subsequent cycles were compared to those who did not. Additionally, for patients who conceived at last, variables related to ovarian stimulation were compared between the first cycle and the conceiving cycle. In accordance with the inclusion criteria, 529 were enrolled during the study period, of which 230 had successful pregnancies and 192 gave birth to a live infant. Cumulative live birth rates (CLBR) per cycle and patient were 26% and 36% respectively. Moreover, 99% of the live births were obtained within the first three attempts, beyond six cycles, there was no pregnancy. Stimulating variables in the first cycle were not effective in predicting the likelihood of a patient's subsequent pregnancy. Overall, patients who did not have embryos available for transfer in the first cycle had a 36% chance of getting a live birth in subsequent attempts, and the cause of failure should be considered.

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Section: Discussionmentioning

confidence: 99%

Live birth rate following a failed first in vitro fertilization cycle with no embryos for transfer

Xiang

Xue

2023

Sci Rep

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Risk factors for poor oocyte yield and oocyte immaturity after GnRH agonist triggering

Gambini,

Sonigo,

Robin

et al. 2024

Human Reproduction

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STUDY QUESTION What are the potential risk factors for poor oocyte recuperation rate (ORR) and oocyte immaturity after GnRH agonist (GnRHa) ovulation triggering? SUMMARY ANSWER Lower ovarian reserve and LH levels after GnRHa triggering are risk factors of poor ORR. Higher BMI and anti-Müllerian hormone (AMH) levels are risk factors of poor oocyte maturation rate (OMR). WHAT IS KNOWN ALREADY The use of GnRHa to trigger ovulation is increasing. However, some patients may have a suboptimal response after GnRHa triggering. This suboptimal response can refer to any negative endpoint, such as suboptimal oocyte recovery, oocyte immaturity, or empty follicle syndrome. For some authors, a suboptimal response to GnRHa triggering refers to a suboptimal LH and/or progesterone level following triggering. Several studies have investigated a combination of demographic, clinical, and endocrine characteristics at different stages of the treatment process that may affect the efficacy of the GnRHa trigger and thus be involved in a poor endocrine response or efficiency but no consensus exists. STUDY DESIGN, SIZE, DURATION Bicentric retrospective cohort study between 2015 and 2021 (N = 1747). PARTICIPANTS/MATERIALS, SETTING, METHODS All patients aged 18–43 years who underwent controlled ovarian hyperstimulation and ovulation triggering by GnRHa alone (triptorelin 0.2 mg) for ICSI or oocyte cryopreservation were included. The ORR was defined as the ratio of the total number of retrieved oocytes to the number of follicles >12 mm on the day of triggering. The OMR was defined as the ratio of the number of mature oocytes to the number of retrieved oocytes. A logistic regression model with a backward selection method was used for the analysis of risk factors. Odds ratios (OR) are displayed with their two-sided 95% confidence interval. MAIN RESULTS AND THE ROLE OF CHANCE In the multivariate analysis, initial antral follicular count and LH level 12-h post-triggering were negatively associated with poor ORR (i.e. below the 10th percentile) (OR: 0.61 [95% CI: 0.42–0.88]; P = 0.008 and OR: 0.86 [95% CI: 0.76–0.97]; P = 0.02, respectively). A nonlinear relationship was found between LH level 12-h post-triggering and poor ORR, but no LH threshold was found. A total of 25.3% of patients suffered from oocyte immaturity (i.e. OMR < 75%). In the multivariate analysis, BMI and AMH levels were negatively associated with an OMR < 75% (OR: 4.34 [95% CI: 1.96–9.6]; P < 0.001 and OR: 1.22 [95% CI: 1.03–1.12]; P = 0.015, respectively). Antigonadotrophic pretreatment decreased the risk of OMR < 75% compared to no pretreatment (OR: 0.72 [95% CI: 0.57–0.91]; P = 0.02). LIMITATIONS, REASONS FOR CAUTION Our study is limited by its retrospective design and by the exclusion of patients who had hCG retriggers. However, this occurred in only six cycles. We were also not able to collect information on the duration of pretreatment and the duration of wash out period. WIDER IMPLICATIONS OF THE FINDINGS In clinical practice, to avoid poor ORR, GnRHa trigger alone should not be considered in patients with higher BMI and/or low ovarian reserve, balanced by the risk of ovarian hyperstimulation syndrome. In the case of a low 12-h post-triggering LH level, practicians must be aware of the risk of poor ORR, and hCG retriggering could be considered. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER N/A.

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Low LH level does not indicate poor IVF cycle outcomes with GnRh-a single trigger: a retrospective analysis

Cited by 2 publications

References 22 publications

Live birth rate following a failed first in vitro fertilization cycle with no embryos for transfer

Live birth rate following a failed first in vitro fertilization cycle with no embryos for transfer

Risk factors for poor oocyte yield and oocyte immaturity after GnRH agonist triggering

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