Luteinizing hormone and its dilemma in ovulation induction

Kumar, Pratap; Sait, Sameer Farouk

doi:10.4103/0974-1208.82351

Cited by 77 publications

(51 citation statements)

References 22 publications

(20 reference statements)

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“…Published evidence suggesting that high levels of LH can lead to follicular atresia and spontaneous abortion (Howles et al, 1986;Stanger and Yovich, 1985) has led to the concept of a 'therapeutic window' for LH to stimulate optimal oestradiol production and promote success in assisted reproduction techniques and ovulation induction (Kumar and Sait, 2011;Shoham, 2002). The primary end-point of the current study suggests that both regimens are within the LH therapeutic Table 3 Treatment outcomes for patients receiving recombinant human folliclestimulating hormone (rhFSH) plus recombinant human luteinizing hormone (rhLH ) (2:1) from stimulation day 1 (group A), or rhFSH from days 1-5, then rhFSH plus rhLH (2:1) from day 6 (group B) (secondary end-points; modified intention-to-treat population unless otherwise specified).…”

Section: Discussionmentioning

confidence: 97%

Randomized trial comparing luteinizing hormone supplementation timing strategies in older women undergoing ovarian stimulation

Behre¹,

Howles²,

Longobardi

2015

Reproductive BioMedicine Online

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In this open-label study, women aged 36-40 years undergoing ovarian stimulation were randomized to recombinant human FSH (rhFSH) plus recombinant human luteinizing hormone (rhLH) from stimulation day 1 (group A; n = 103), or rhFSH alone (days 1-5) followed by rhFSH plus rhLH from day 6 (group B; n = 99). The primary objective was equivalence in number of oocytes retrieved per patient. The mean (±SD) number of oocytes retrieved was 9.7 (±6.9) in group A and 10.9 (±6.5) in group B; the estimated difference between groups (-1.28 oocytes [95% confidence interval: -3.15 to 0.59]) did not reach the predefined limit of equivalence (±3 oocytes). The study's primary objective was therefore not met. In both groups, a mean (±SD) of 1.9 (±0.6) embryos were transferred per patient. Implantation rates were 24.7% in group A and 13.3% in group B. Clinical pregnancy rates per started cycle and per embryo transfer were 31.6% and 34.4% in Group A, 17.2% and 18.9% in Group B. Ovarian hyperstimulation syndrome was reported in four (group A) and five (group B) patients. The potential benefit of initiating LH supplementation earlier during ovarian stimulation in older women is of interest, warranting further exploration.

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Section: Discussionmentioning

confidence: 97%

Randomized trial comparing luteinizing hormone supplementation timing strategies in older women undergoing ovarian stimulation

Behre¹,

Howles²,

Longobardi

2015

Reproductive BioMedicine Online

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“…Contrary, high LH activities cause binding of granulosa cells followed by follicles luteinisation and receptor down regulation leading untimely premature ovulations [40,44] and the transport of the gametes to fertilization site are associated with problems [45]. On the other side, low LH activities cause deviation in oocyte maturation, fertilization and early embryonic development [46]. However, not only, FSH:LH ratio could be affecting the ovarian response and embryos quality.…”

Section: Discussionmentioning

confidence: 99%

Impact of Type and Dose of Recombinant Human Follicle Stimulating Hormone on Embryos Production in Dairy Cows and Their Relationship with AMH Concentration

Mohammed¹,

Darwish²,

Dohreig³

et al. 2019

AVS

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The study was investigated to compare the effectiveness of Folltropin and two products (Fostimon and Menogon) of a recombinant human follicle stimulating hormone (rhFSH) on ovarian super-stimulation and embryo production in dairy Holstein cows. Two different doses for each super-ovulatory product were investigated. The relationship between the levels of Anti-Mullerian Hormone (AMH) in the blood serum before super-stimulation initiation and ovarian response and embryos production were also evaluated. At random stage of the estrus cycle, the donor cows were received intra-vaginal controlled internal drug release device (CIDR) and injected with 100µg of gonadotropin-releasing hormone (GnRH). On fourth day of CIDR insertion, cows were divided according to the product types of superovulatory hormones into three equal main groups. According to hormonal dose, each main group was re-divided into two equally subgroups ; low and high dose. Superovulatory hormones was injected IM as decreasing doses; 40%, 30%, 20% and 10% of the total dose twice daily for 4 days. On day 7, CIDRs were removed and each cow received 2 doses of PGF 2 α with 12hr interval. Based upon heat detection, donor's cows were inseminated with frozen semen three times 8-10hrs interval and concurrent with 100µg GnRH injection at first insemination. Non-surgical embryos recovery was performed on day's 7-8 post insemination and ovarian super-stimulation was checked using sonography to estimate ovarian response. Recovered embryos were morphologically evaluated as grades. Twelve embryos collected from Menogon donors group were transferred to six recipient's cows. The mean numbers of CL, recovered embryo/ova, fertilized ova and transferable embryos are significantly (P<0.01) higher in Folltropin and Menogon treated cows than Fostimon group. Donor cows treated with high doses of Folltropin and Menogon showed higher means for transferable and freezable embryos. Three recipients (50%) who received embryos appeared pregnant and one of them born calf. Significant positive correlations were reported between AMH on one side and CL, total ovarian response, transferable and freezable embryos on the other side, and cows having AMH≥230ng/L exhibited significant higher means. In conclusion: Menogon can be used as rhFSH for embryos production with transferable quality. AMH can be used as indicator to helpful select cow's candidates as donors. More studies are needed using Fostimon accompanied with different levels of LH.

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“…The combination of both premature LH rise (≥10 mIU/mL) and premature progesterone rise (variable cut-off values ranging from 0.8 to 2.0 ng/mL) is indicative of a premature LH surge [20]. Premature LH rise results in acquiring of LH receptors by the granulosa cells with early luteinization and follicular atresia [21]. Premature progesterone rise causes premature transformation of the endometrium into secretory one resulting in an asynchrony between the endometrium and the embryos transferred to it with reduction in pregnancy rates [22,23].…”

Section: Discussionmentioning

confidence: 99%

Accelerated Coasting Does Not Affect Oocyte Maturation

Galal

Abbassy²,

Abdel‐Rahman³

et al. 2017

Gynecol Obstet Invest

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Aims: The study aimed to assess the efficacy of accelerating the process of coasting through adding gonadotropin releasing hormone (GnRH) antagonist (GnRH-ant) on the day of triggering of oocyte maturation without withholding the GnRH agonist (GnRHa) in women at risk for developing ovarian hyperstimulation syndrome (OHSS). Methods: Retrospective case-control study of the outcomes of GnRHa cycles in which women were at risk to develop OHSS. Women who underwent acceleration of coasting (n = 50) were compared with a control group of women who underwent usual coasting (n = 57). Results: The oocyte maturation and fertilization rates were significantly higher in the accelerated coasting group than in the usual coasting group (83.05 vs. 67.62%; p < 0.001 and 79.85 vs. 65.84%; p < 0.001, respectively). The pregnancy rates were higher in the accelerated coasting group than in the usual coasting group but without statistically significant difference. The incidences of mild, moderate, and severe OHSS were not significantly different between both groups. Conclusion: Acceleration of coasting in cases of OHSS through treatment with GnRH-ant after pituitary suppression with GnRHa offered a novel approach to reduce estradiol level, avoid cycle cancellation, and maintain excellent oocyte maturation rate and thus high pregnancy rate with prevention of OHSS.

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Luteinizing hormone and its dilemma in ovulation induction

Cited by 77 publications

References 22 publications

Randomized trial comparing luteinizing hormone supplementation timing strategies in older women undergoing ovarian stimulation

Randomized trial comparing luteinizing hormone supplementation timing strategies in older women undergoing ovarian stimulation

Impact of Type and Dose of Recombinant Human Follicle Stimulating Hormone on Embryos Production in Dairy Cows and Their Relationship with AMH Concentration

Accelerated Coasting Does Not Affect Oocyte Maturation

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