Author/Authors :
Bleau، Nathalie نويسنده Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada , , Agdi، Mohammed نويسنده Department of Reproductive Endocrinology and Infertility, McGill Reproductive Center, McGill University, Montreal, Quebec, Canada , , Son، WeonYoung نويسنده Department of Reproductive Endocrinology and Infertility, McGill Reproductive Center, McGill University, Montreal, Quebec, Canada , , Tan، SeangLin نويسنده Department of Reproductive Endocrinology and Infertility, McGill Reproductive Center, McGill University, Montreal, Quebec, Canada , , Dahan، Michael H نويسنده Department of Reproductive Endocrinology and Infertility, McGill Reproductive Center, McGill University, Montreal, Quebec, Canada ,
Abstract :
Background: This study compared rates of pregnancy and in vitro fertilization (IVF)
parameters in subjects stimulated with follicle stimulating hormone (FSH) plus either
recombinant human luteinizing hormone (r-LH) or human menopausal gonadotropin
(hMG) in a long gonadotropin releasing hormone (GnRH) agonist IVF protocol.
Materials and Methods: This cohort study enrolled patients who underwent IVF stimulation
with a long GnRH agonist protocol and received FSH plus r-LH or hMG. Outcomes
measured included: FSH and LH doses, number of oocytes and embryos obtained,
pregnancy rate per cycle, and clinical pregnancy rate per cycle. Stepwise logistic regression
was performed on continuous and categorical variables to control for confounding
effects between all variables analyzed.
Results: There were 122 patients who underwent 122 IVF cycles with long GnRH agonist
protocols. Similar baseline parameters existed between groups. Patients that received r-LH
required a lower FSH dose (3207 ± 1300 IU) for stimulation compared to the group that received
hMG (4213 ± 1576 IU, P=0.0001). The LH dose was also lower in these patients (1332
± 587 IU) compared to the patients who received hMG (1938 ± 1110 IU, P=0.0001). The
number of days of stimulation did not differ between groups (P=1.0). The group that received
r-LH also had statistically higher numbers of oocytes (14.4 ± 6.3) and embryos (7.9 ± 4.8)
compared to the hMG group with 11.0 ± 5.3 oocytes and 6.0 ± 3.7 embryos. Pregnancy rates
per cycle start were higher for patients in the r-LH group (49%) compared to the hMG group
(27%, P=0.025). Patients that received r-LH had higher implantation rates (62%) compared
to the hMG group (33%, P=0.001). The r-LH group had a higher trend toward clinical pregnancy
rates per cycle start (39%) compared to the hMG group (25%, P=0.065).
Conclusion: r-LH may offer benefits compared to hMG when combined with FSH for
ovarian stimulation in long GnRH agonist protocols in good responders. Prospective studies
should be undertaken to confirm these results.
