Abstract

We performed a retrospective study aiming to study the relationship between the ratio of the exogenous luteinizing hormone to follicle stimulating hormone (LH/FSH) administrated for controlled ovarian stimulation (COS) and the number and competence of the oocytes retrieved for in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Eight hundred sixty-eight consecutive infertile patients (mean age 34.54 ± 4.01 years, mean anti-Müllerian hormone (AMH) 2.94 ± 2.07 ng/ml) treated with long agonist protocol and a mixed gonadotropin protocol (human menopausal gonadotropin in association with recombinant FSH (recFSH)) who performed IVF/ICSI between January 2013 and February 2016, were included. Patients with severe male factor were excluded. LH/FSH was calculated based on total doses of the two gonadotropins. We found, after adjustment for confounders, a positive relationship between LH/FSH and the retrieved oocytes’ (β = 0.229, P<0.0001) and zygotes’ number (β = 0.144, P<0.0001) in the entire study group and in subgroups according to age (<35 and ≥35 years) and ovarian reserve (AMH < 1.1 and ≥ 1.1 ng/ml). The fertilization rate was positively associated with LH/FSH in patients with LH/FSH in the lowest three quartiles (below 0.77) (β = 0.096, P=0.034). However, patients in the fourth quartile of LH/FSH had a lower fertilization rate as compared with patients in quartiles 1–3 which, after adjustment for covariates, was only marginally negatively related with LH/FSH (β = −0.108, P=0.05). In conclusion, our results suggest that the adequate LH/FSH administrated during COS can improve the oocytes’ and zygotes’ number in IVF/ICSI cycles, but also the fertilization rate when a certain proportion of LH/FSH is not exceeded.

Highlights

  • Optimization of the response to assisted reproduction represents a continuous challenge for the practitioners in the reproductive medicine field taking into account the psychological burden of the patients seeking this treatment [1]

  • The results of our study support the importance of an optimal ratio of doses of exogenous luteinizing hormone (LH) to follicle stimulating hormone (FSH) used in controlled ovarian stimulation (COS) before in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) for obtaining a higher oocytes and zygotes number

  • To the best of our knowledge, this is the first study that reports a linear relationship between luteinizing hormone to follicle stimulating hormone (LH/FSH) doses administrated for COS and oocytes and zygotes number

Read more

Summary

Introduction

Optimization of the response to assisted reproduction represents a continuous challenge for the practitioners in the reproductive medicine field taking into account the psychological burden of the patients seeking this treatment [1]. HP-HMG is a gonadotropin extracted from the urine of menopausal women which contains both FSH and LH activities, the latter being mainly derived from the urinary hCG present in HP-HMG These studies found that HP-HMG might be superior to recFSH regarding the live birth rate [11,12,13], some of the embryo quality parameters and implantation rate of the top-quality embryos [14]. It was found a positive relationship between serum HCG level (from HP-HMG composition) and the ongoing pregnancy rate [15,16] and the embryos’ quality [16], supporting the hypothesis that LH activity of HCG is responsible for these outcomes. Our study aimed to analyze whether there is a relationship between the ratio of doses of LH and FSH administrated for COS in patients performing IVF/intracytoplasmic sperm injection (ICSI) and the number of the oocytes obtained at egg collection and their developmental competence

Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call