Optimizing cycle outcomes: the inclusion of exogenous LH activity is important in protecting against a late follicular rise in progesterone (P) in low (LR), normal (NR), and high responders (HR)

Abstract

Late follicular rises in P levels during follicular stimulation have been linked to suboptimal outcomes. It has recently been demonstrated that the ratio of total exLH to exogenous FSH (exFSH) is highly correlated with the risk for late follicular P rise in ART cycles, with the highest risk in cycles utilizing no exLH. Increased risk was also present when exLH:exFSH was either below 0.3 or over 0.6. Given that patients with different intrinsic ovarian responsiveness have varied intra-follicular milieus and gonadotropin sensitivity, it is possible that optimal exLH:exFSH might vary amongst them.