THE BENEFICIAL EFFECT FOR LBR OF SERUM LH (5-10IU/L) ON TRIGGER DAY WITH GnRH ANTAGONIST PROTOCOL

Abstract

To investigate the effect of various serum LH on trigger day with GnRH antagonist protocol in patients receiving in-vitro fertilization (IVF) /Intracytoplasmic sperm injection (ICSI) for pregnancy outcomes. A retrospective, single-center cohort study. Setting: We retrospectively reviewed the medical documents of patients receiving IVF/ICSI with fresh embryo transfers in the Reproductive Medicine Center of Peking University People's Hospital between January 2016 and December 2018. Patients: 894 patients were included and divided into three groups by various serum LH on trigger day. Interventions: Group A ,Group B and Group C were defined as LH concentration <1.0 IU/l, ≥1.0 IU/l and ≤5.0 IU/l, >5.0 IU/l and ≤10.0 IU/l on trigger day during the cycle, respectively. Main Outcome Measures: implantation rate, clinical pregnancy rate, early pregnancy loss rate and live-birth rate (LBR). Pregnancy results were compared among these three groups. There was significant difference in implantation rates between Group A and Group C (20.57%versus 35.90%, respectively). The clinical pregnancy rates (35.42% versus 48.65%) and LBR (29.17% versus 41.89%) appeared higher in Group C, though the differences were not significant. According to Multivariate logistic regression analysis, compared with Group A, the LBR of Group B(OR=4.160, P = 0.039) and Group C(OR=5.037, P = 0.034) increase and the differences were significant. Our study has proposed Chinese patients in 5-10 IU/l of the serum LH on trigger day with GnRH antagonist protocol may have better clinical outcomes than 1-5IU/l of LH. So the serum LH on trigger day with GnRH antagonist protocol should not be very low. The level of LH should be beneficial for outcomes in our suggested LH range. Whereas, we still need more adequate sample size and multi-center research to make RCTs and in-depth study on the mechanism.