High basal LH levels are associated with improved cycle outcomes of assisted reproduction
Keywords:Luteinizing hormone, IVF (in-vitro fertilization), Infertility, Oocyte number, Pregnancy rate
Aim: Several parameters are used to observe the ovarian responsiveness to gonadotropin stimulation. Basal LH levels have been suggested on ovarian response as well as basal FSH levels. This study was aimed to evaluate the correlation of basal LH levels with cycle and pregnancy outcomes in patients who underwent GnRH-antagonist IVF (in-vitro fertilization) cycles.
Methods: This retrospective cohort study recruited a total of 317 cycles with values of FSH <10 IU/L. Basal hormonal parameters (FSH, LH, estradiol) were recorded prior to ovarian stimulation. Patients were treated with GnRH antagonist protocols and stimulated with recombinant FSH. The patients were categorized according to designated threshold levels for LH values (Group 1: LH <4.1 IU/L and Group 2: LH 4.1). The number of total retrieved oocytes and mature oocytes, implantation rate, clinical pregnancy rate and ongoing pregnancy rate were analyzed between study groups.
Results: Group 2 had a higher number of retrieved oocytes and mature oocytes compared to Group 1 (P=0.006 and P=0.03, respectively). Although not statistically significant, there was a trend towards higher rates of pregnancy on high LH levels. Clinical and ongoing pregnancy rates were insignificantly lower in Group 1 (38.3% vs. 48.5%, P=0.162 and 29.4% vs. 34.0%, P=0.535; respectively). The basal LH levels positively correlated with the number of oocytes, and the combination with low FSH levels was also found to be associated with higher number of retrieved oocytes and peak estradiol levels.
Conclusions: Elevated basal LH levels provide a beneficial effect on cycle outcome such as number of retrieved oocytes. However, clinical pregnancy rates were found to be similar between below and above the threshold of LH levels.
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