Introduction: Although the fundamental significance of both LH and FSH for adequate ovarian folliculogenesis and steroidgenesis has been extensively discussed, the clinical implication of recombinant (r) LH for ovarian stimulation remains to be elucidated.
Aim: To explore whether rLH supplementation to rFSH following GnRH antagonist treatment has an advantage in infertile women with advanced reproductive ageing undergoing IVF-ET.
Materials: Sixty three consecutive infertile women above 35 years of age and/or with a previous low ovarian response admitted for IVF/ICSI treatment were prospectively recruited. All women were similarly treated employing the recombinant FSH (Gonal-F) 300 IU/day and the flexible GnRH antagonist (Cetrotide) 0.25 mg/day protocol. On the same day of the antagonist start, r-LH (Luveris) 150 IU/day was added only to the study group and continued till the hCG day.
Results: Patients' characteristics including basal ovarian reserve studies were similar in both the study and control groups. Although rLH addition has reduced the GnRH antagonist duration from 5.0±1.5 to 4.2±1.7 days (P < 0.5) in the study as compared to the control group, it did not change total dosage of rFSH administered, maximal E2 level and follicular phase duration. Moreover, number of > 14mm follicles, oocytes, MII oocytes, 2PN zygotes, embryos and top graded embryos did not change between the two groups. Endometrial thickness, implantation and pregnancy rates were also similar between the groups.
Conclusions: Primary evaluation of our results does not reveal an obvious advantage regarding rLH addition to the rFSH/GnRH antagonist flexible protocol in the advanced reproductive ageing women.
