ABSTRACT

OBJECTIVE:

Luteinizing hormone (LH) requirement in assisted reproductive treatment (ART) cycles is still controversial. The objective of this study was to investigate the impact of providing LH activity with recombinant LH (rLH) on the oocyte and embryo quality in both GnRH agonist long and antagonist ART cycles of normoresponder women <40 years.

MATERIALS-METHODS:

A retrospective cohort study of 351 normoresponder IVF patients <40 years was carried out. Agonist long protocol was given in 184 women and antagonist in 167. Stimulation was performed in both protocols with either recombinant follicle stimulating hormone (rFSH) alone or rFSH plus rLH. Cycle characteristics and outcomes, primarily the proportions of mature oocytes and good-quality embryos were evaluated according to rLH addition in two most commonly used stimulation protocols.

RESULTS:

In agonist long protocol, a significantly higher number of total oocytes (17.6±5.8 vs. 15±6.8; p=0.005) and a significantly higher rate of mature oocytes (75% vs. 70%; p=0.02) were obtained, although embryo quality was similar in rFSH alone cycles compared to rLH supplemented ones. In antagonist protocol, significantly more oocytes were retrieved in rFSH alone group (16.3±7.5 vs 12.8±5.1; p=0.001), although this did not reflect into oocyte maturation and embryo development. Fertilization, implantation, clinical pregnancy, miscarriage and ongoing pregnancy rates didnot differ when rLH was added in both protocols.

CONCLUSION:

Recombinant LH supplementation in agonist long ART cycles was found to have a detrimental effect on the oocyte quality, however no beneficial or adverse effect on the embryo quality in normoresponder women <40 years. Addition of rLH during stimulation in antagonist ART cycles, on the other hand, is neither favorable nor deleterious for the oocyte and the embryo quality in normoresponder women <40 years.