International Journal of
Reproductive Biomedicine
Fri, Feb 7, 2025
[Archive]
Volume 12, Issue 2 (2-2014)
IJRM 2014, 12(2): 111-116 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Razi M, Mohseni F, Dehghani Firouzabadi R, Janati S, Yari N, Etebary S. Results from adding recombinant LH for assisted reproductive technology treatment: A randomized control trial. IJRM 2014; 12 (2) :111-116
URL: http://ijrm.ir/article-1-511-en.html
URL: http://ijrm.ir/article-1-511-en.html
Mohammad-Hossein Razi1 
, Fereshteh Mohseni * 2, Razieh Dehghani Firouzabadi1 , Sima Janati1 , Nahid Yari1 , Sahabeh Etebary1
, Fereshteh Mohseni * 2, Razieh Dehghani Firouzabadi1 , Sima Janati1 , Nahid Yari1 , Sahabeh Etebary1
1- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,fereshtehmohseni73@gmail.com
2- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,
Abstract: (2852 Views)
Background: Based on classical two-cell, two-gonadotropin theory, in the follicle, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) put on their main effects on the granulosa and theca cells. LH is essential for androgens production. Androgens are used for estradiol production by granulosa cells. Profound suppression of LH concentrations in some normogonadotropic patients can cause several adverse effects.
Objective: The main clinical purpose of this study was that normoresponder women treated with controlled ovarian super ovulation for IVF or ICSI may benefit from co-administration of rLH.
Materials and Methods: 40 patients who were candidates for assisted reproductive technology (ART) were randomly selected. In all patients long luteal protocol was used for ovulation induction. Patients were randomly divided into two groups: Group 1 (n=20) with standard long protocol (GnRH agonist) and r-FSH alone, Group 2 (n=20) with standard long protocol (GnRH agonist) and r-FSH with r-LH. Results were statistically analyzed and compared in two groups.
Results: The number of retrieved oocytes, mature oocytes, cleaved embryos, transferred embryos, estradiol levels in Human chorionic gonadotropin (hCG) administration day, implantation rate and clinical pregnancy rate in group 2 were higher but not significantly different.
Conclusion: Administration of rLH in late follicular phase had no beneficial effect on outcomes in young women with mean age of 31 years. Maybe a greater sample size should be used to see the effects more accurately; also it is possible that rLH will be useful in older patients.
Objective: The main clinical purpose of this study was that normoresponder women treated with controlled ovarian super ovulation for IVF or ICSI may benefit from co-administration of rLH.
Materials and Methods: 40 patients who were candidates for assisted reproductive technology (ART) were randomly selected. In all patients long luteal protocol was used for ovulation induction. Patients were randomly divided into two groups: Group 1 (n=20) with standard long protocol (GnRH agonist) and r-FSH alone, Group 2 (n=20) with standard long protocol (GnRH agonist) and r-FSH with r-LH. Results were statistically analyzed and compared in two groups.
Results: The number of retrieved oocytes, mature oocytes, cleaved embryos, transferred embryos, estradiol levels in Human chorionic gonadotropin (hCG) administration day, implantation rate and clinical pregnancy rate in group 2 were higher but not significantly different.
Conclusion: Administration of rLH in late follicular phase had no beneficial effect on outcomes in young women with mean age of 31 years. Maybe a greater sample size should be used to see the effects more accurately; also it is possible that rLH will be useful in older patients.
Type of Study: Original Article |
References
1. Gougeon A. Regulation of ovarian follicular development in primates: facts and hypotheses. Endocr Rev 1996; 17: 121-155. [DOI:10.1210/edrv-17-2-121]
2.
2. Fevold H. Synergism of the follicle stimulating and luteinizing hormones in producing ogen secretion. Endocrinology 1941; 28: 33-36. [DOI:10.1210/endo-28-1-33]
3. Schoot DC, Coelingh Bennink HJ, Mannaerts BM, Lamberts SW, Bouchard P, Fauser BC. Human recombinant follicle-stimulating hormone induces growth of preovulatory follicles without concomitant increase in androgen and estrogen biosynthesis in a woman with isolated gonadotropin deficiency. J Clin Endocrinol Metab 1992; 74: 1471-1473.
4. Filicori M, Cognigni GE. Roles and Novel Regimens of Luteinizing Hormone and Follicle-Stimulating Hormone in Ovulation Induction. J Clin Endocrinol Metab 2001; 86: 1437-1441.
5. Caglar GS, Asimakopoulos B, Nikolettos N, Diedrich K, Al-Hasani S. Recombinant LH in ovarian stimulation. Reprod Biomed Online 2005; 10: 774-785. [DOI:10.1016/S1472-6483(10)61123-6]
6. Westergaard LG, Erb K, Laursen SB, Rex S, Rasmussen PE. Human menopausal gonadotropin versus recombinant follicle-stimulating hormone in normogonadotropic women down-regulated with a gonadotropin-releasing hormone agonist who were undergoing in vitro fertilization and intracytoplasmic sperm injection: a prospective randomized study. Fertil Steril 2001; 76: 543-549. [DOI:10.1016/S0015-0282(01)01973-2]
7. Westergaard LG, Erb K, Laursen S, Rasmussen PE, Rex S. The effect of human menopausal gonadotrophin and highly purified, urine-derived follicle stimulating hormone on the outcome of in-vitro fertilization in down-regulated normogonadotrophic women. Hum Reprod 1996; 11: 1209-1213. [DOI:10.1093/oxfordjournals.humrep.a019357]
8. Westergaard LG, Laursen SB, Andersen CY. Increased risk of early pregnancy loss by profound suppression of luteinizing hormone during ovarian stimulation in normogonadotrophic women undergoing assisted reproduction. Hum Reprod 2000; 15: 1003-1008. [DOI:10.1093/humrep/15.5.1003]
9. Fleming R, Lloyd F, Herbert M, Fenwick J, Griffiths T, Murdoch A. Effects of profound suppression of luteinizing hormone during ovarian stimulation on follicular activity, oocyte and embryo function in cycles stimulated with purified follicle stimulating hormone. Hum Reprod 1998; 13: 1788-1792. [DOI:10.1093/humrep/13.7.1788]
10. Janssens RM, Lambalk CB, Vermeiden JP, Schats R, Bernards JM, Rekers-Mombarg LT, et al. Dose-finding study of triptorelin acetate for prevention of a premature LH surge in IVF: a prospective, randomized, double-blind, placebo-controlled study. Hum Reprod 2000; 15: 2333-2340. [DOI:10.1093/humrep/15.11.2333]
11. Filicori M, Cognigni GE, Taraborrelli S, Spettoli D, Ciampaglia W, de Fatis CT, et al. Luteinizing hormone activity supplementation enhances follicle-stimulating hormone efficacy and improves ovulation induction outcome. J Clin Endocrinol Metab 1999; 84: 2659-2663. [DOI:10.1210/jc.84.8.2659]
12. Lisi F, Rinaldi L, Fishel S, Caserta D, Lisi R, Campbell A. Evaluation of two doses of recombinant luteinizing hormone supplementation in an unselected group of women undergoing follicular stimulation for in vitro fertilization. Fertil Steril 2005; 83: 309-315. [DOI:10.1016/j.fertnstert.2004.07.969]
13. Humaidan P, Bungum M, Bungum L, Yding Andersen C. Effects of recombinant LH supplementation in women undergoing assisted reproduction with GnRH agonist down-regulation and stimulation with recombinant FSH: an opening study. Reprod Biomed Online 2004; 8: 635-643. [DOI:10.1016/S1472-6483(10)61643-4]
14. Wong PC, Qiao J, Ho C, Ramaraju GA, Wiweko B, Takehara Y, et al. Current opinion on use of luteinizing hormone supplementation in assisted reproduction therapy: an Asian perspective. Reprod Biomed Online 2011; 23: 81-90. [DOI:10.1016/j.rbmo.2011.03.023]
15. Chung K, Krey L, Katz J, Noyes N. Evaluating the role of exogenous luteinizing hormone in poor responders undergoing in vitro fertilization with gonadotropin-releasing hormone antagonists. Fertil Steril 2005; 84: 313-318. [DOI:10.1016/j.fertnstert.2005.02.028]
16. Humaidan P, Bungum L, Bungum M, Andersen CY. Ovarian response and pregnancy outcome related to mid-follicular LH levels in women undergoing assisted reproduction with GnRH agonist down-regulation and recombinant FSH stimulation. Hum Reprod 2002; 17: 2016-2021. [DOI:10.1093/humrep/17.8.2016]
17. Ireland JJ, Richards JS. A previously undescribed role for luteinizing hormone (LH: hCG) on follicular cell differentiation. Endocrinology 1978; 102: 1458-1465. [DOI:10.1210/endo-102-5-1458]
18. Iwai T, Nanbu Y, Iwai M, Taii S, Fujii S, Mori T. Immunohistochemical localization of oestrogen receptors and progesterone receptors in the human ovary throughout the menstrual cycle. Virchows Arch A Pathol Anat Histopathol 1990; 417: 369-375. [DOI:10.1007/BF01606025]
19. Park OK, Mayo KE. Transient Expression of Progesterone Receptor Messenger RNA in Ovarian Granuiosa Cells after the Preovulatory Luteinizing Hormone Surge. Mol Endocrinol 1991; 5: 967-978. [DOI:10.1210/mend-5-7-967]
20. Sagle M, Bishop K, Ridley N, Alexander FM, Michel M, Bonney RC, et al. Recurrent early miscarriage and polycystic ovaries. BMJ 1988; 297: 1027-1028. [DOI:10.1136/bmj.297.6655.1027]
21. Regan L, Owen E, Jacobs HS. Hypersecretion of luteinizing hormone, infertility and miscarriage. Lancet 1990; 336: 1141-1144. [DOI:10.1016/0140-6736(90)92765-A]
22. Chappel SC, Howles C. Review Reevaluation of the roles of luteinizing hormone and follicle-stimulating hormone in the ovulatory process. Hum Reprod 1991; 6: 1206-1212. [DOI:10.1093/oxfordjournals.humrep.a137513]
23. Zeleznik AJ, Hillier SG. The role of gonadotropins in the selection of the preovulatory follicle. Clin Obstet Gynecol 1984; 27: 927-940. [DOI:10.1097/00003081-198412000-00014]
24. Howles CM, Loumaye E, Giroud D, Luyet G. Multiple follicular development and ovarian steroidogenesis following subcutaneous administration of a highly purified urinary FSH preparation in pituitary desensitized women undergoing IVF: a multicentre European phase III study. Hum Reprod 1994; 9: 424-430. [DOI:10.1093/oxfordjournals.humrep.a138522]
25. Loumaye E, Engrand P, Howles CM, O'Dea L. Assessment of the role of serum luteinizing hormone and estradiol response to follicle-stimulating hormone on in vitro fertilization treatment outcome. Fertil Steril 1997; 67: 889-899. [DOI:10.1016/S0015-0282(97)81402-1]
26. Liu HC, Davis O, Berkeley A, Graf M, Rosenwaks Z. Late luteal estradiol patterns are a better prognosticator of pregnancy outcome than serial beta-human chorionic gonadotropin concentrations. Fertil Steril 1991; 56: 421-426. [DOI:10.1016/S0015-0282(16)54534-8]
27. Davis O, Rosenwaks Z. Current status of invitro fertilization and new reproductive technologies. Cur Opin Obstet Gynecol 1992; 4: 354-358. [DOI:10.1097/00001703-199206000-00003]
28. Damario MA, Davis OK, Rosenwaks Z. The endocrinology of the assisted reproductive technologies. Cur Opin Endocrinol Diabetes and Obesity 1995; 2: 493-499. [DOI:10.1097/00060793-199512000-00005]
29. Marrs R, Meldrum D, Muasher S, Schoolcraft W, Werlin L, Kelly E. Randomized trial to compare the effect of recombinant human FSH (follitropin alfa) with or without recombinant human LH in women undergoing assisted reproduction treatment. Reprod Biomed Online 2004; 8: 175-182. [DOI:10.1016/S1472-6483(10)60513-5]
30. Balasch J, Vidal E, Pe-arrubia J, Casamitjana R, Carmona F, Creus M, et al. Suppression of LH during ovarian stimulation: analysing threshold values and effects on ovarian response and the outcome of assisted reproduction in down-regulated women stimulated with recombinant FSH. Hum Reprod 2001; 16: 1636-1643. [DOI:10.1093/humrep/16.8.1636]
31. Balasch J, Pe-arrubia J, Fábregues F, Vidal E, Casamitjana R, Manau D, et al. Ovarian responses to recombinant FSH or HMG in normogonadotrophic women following pituitary desensitization by a depot GnRH agonist for assisted reproduction. Reprod Biomed Online 2003; 7: 35-42. [DOI:10.1016/S1472-6483(10)61726-9]
32. Oliveira JB, Mauri AL, Petersen CG, Martins AM, Cornicelli J, Cavanha M, et al. Recombinant luteinizing hormone supplementation to recombinant follicle-stimulation hormone during induced ovarian stimulation in the GnRH-agonist protocol: A meta-analysis. J Assist Reprod Genet 2007; 24: 67-75. [DOI:10.1007/s10815-006-9095-4]
33. Agrawal R, Holmes J, Jacobs HS. Follicle-stimulating hormone or human menopausal gonadotropin for ovarian stimulation in in vitro fertilization cycles: a meta-analysis. Fertil Steril 2000; 73: 338-343. [DOI:10.1016/S0015-0282(99)00519-1]
34. Sills ES, Levy DP, Moomjy M, McGee M, Rosenwaks Z. A prospective, randomized comparison of ovulation induction using highly purified follicle-stimulating hormone alone and with recombinant human luteinizing hormone in in-vitro fertilization. Hum Reprod 1999; 14: 2230-2235. [DOI:10.1093/humrep/14.9.2230]
35. Tarlatzis B, Tavmergen E, Szamatowicz M, Barash A, Amit A, Levitas E, et al. The use of recombinant human LH (lutropin alfa) in the late stimulation phase of assisted reproduction cycles: a double-blind, randomized, prospective study. Hum Reprod 2006; 21: 90-94. [DOI:10.1093/humrep/dei293]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
