Beneficial effects of residual LH levels after GnRH agonist on ovarian response to rFSH, embryo quality, and IVF-ET outcome.

Abstract

Objective: By the mid-follicular phase of the menstrual cycle, progressive LH secretion parallels the acquisition of LH receptors by the granulosa cells, a phenomenon that may assist final oocyte-follicular maturation and ovulation. In COH, GnRH agonist pretreatment often leads to extensive suppression of endogenous LH activity. By definition, defective LH activity is not subsequently compensated by FSH-only recombinant preparations and such an unbalanced endocrine milieu may alter oocyte-follicular quality. Yet, previous studies addressing this issue have led to divergent conclusions (Scott Sills et al., Hum Reprod, 1999; Fleming et al., Hum Reprod, 1998). Hence, to clarify this point, we assessed possible differences in ovarian response to COH, embryology data, and IVF-ET outcome in women having consistently low or high residual LH levels after pretreatment with GnRH agonist.