The decrease of serum luteinizing hormone level by a gonadotropin-releasing hormone antagonist following the mild IVF stimulation protocol for IVF and its clinical outcome

Abstract

Purpose While performing the mild ovarian stimulation protocol with a GnRH antagonist, the pregnancy rate was compared between the groups, which were divided by the degree that the luteinizing hormone (LH) level decreased. Materials and methods Patients aged 27 to 42years (36.1 ± 3.79) underwent 308 IVF cycles who opted for IVF via the mild ovarian stimulation protocol began clomiphene citrate on day 3 and recombinant FSH on day 5. A GnRH antagonist was administered when the dominant follicle reached 14mm. Serum LH was measured at the time of GnRH antagonist administration and at the time of hCG injection. The pregnancy rate and implantation rate were compared between 50 cycles in which the LH level dropped less than one-third and the control (LH level within 1/3). Result(s) The pregnancy rate for the group in which the LH level fell less than one third was 18%. Conversely, the pregnancy rate for the control group was 39%. The implantation rate was 18% for the less than one-third group and 26% for the control group. Both the pregnancy rate and the implantation rate for the group in which the LH level fell less than one-third were significantly lower than that of control (p < 0.02). Conslusion(s) When performing the mild ovarian stimulation protocol, serum LH should be followed. If the serum LH level is less than one-third at the time of hCG injection, both the pregnancy rate and implantation rate are significantly lower.

Public-Private Interaction Model; A Simple Strategy towards Making Assisted Reproduction Accessible in a Poor Resource Setting: A Prospective Descriptive Study

“…The clinical pregnancy rate of 14.1% per started cycle and 23.5% per ET were achieved. These results are similar to those reported in the previous studies [22,[32][33][34] . The live birth rates in this study were 10.6% per cycle and 17.7% per ET.…”

Outcome of in vitro fertilization in patients with proven poor ovarian responsiveness after early vs. mid-follicular LH exposure: a prospective, randomized, controlled study

“…Moreover, a high endogenous LH concentration on days 7/8 of a long protocol stimulation was found to lead to significantly higher oocyte yield and number of available embryos, whereas a sharp drop of serum LH level during the mid-follicular phase was associated with a significantly lower live birth rate in IVF [19]. Similarly, a study on IVF patients undergoing mild ovarian stimulation protocol with GnRH-antagonist reported that the pregnancy and implantation rates were significantly lower if the serum LH levels were low in the late follicular phase [25]. We designed the present study to prospectively analyse IVF outcome in a large series of patients randomized to receive exogenous LH from day 1 or from day 7 of an ovarian stimulation cycle for IVF.…”

“Mild” vs. “long” protocol for controlled ovarian hyperstimulation in patients with expected poor ovarian responsiveness undergoing in vitro fertilization (IVF): a large prospective randomized trial

“…Moreover, it was previously shown that when in CC/Gn/GnRH-ant cycles the circulating LH is less than one-third at the time of hCG than at the beginning of stimulation, both the pregnancy and implantation rates are significantly reduced [23].…”