LH supplementation in down-regulated women undergoing assisted reproduction with baseline low serum LH levels

Gynecol Endocrinol. 2010 Feb;26(2):118-24. LH supplementation in down-regulated women undergoing assisted reproduction with baseline low serum LH levels. Pezzuto A, Ferrari B, Coppola F, Nardelli GB. SourceDepartment of Obstetrics, Gynaecology and Neonatology, University of Parma, Centre for Reproductive Medicine, Parma, Italy. antoniocosimopezzuto@virgilio.it Abstract AIM: The aim of our study is to evaluate the effect of recombinant-human LH supplementation on ovarian response and pregnancy outcome, during ovarian stimulation, in down-regulated women with baseline low serum LH levels undergoing assisted reproductive technology. STUDY DESIGN: A prospective randomized study performed with 80 women, with serum LH levels 50.5 IU/l on cycle Day 6 of stimulation. Group-A (40): 14-days after down-regulation with leuprorelin, ovarian stimulation was initiated only with r-FSH 225 IU. Group-B (40): at the same time stimulation was initiated with rFSH 225 IU associated with rLH 75 UI on cycle Day 6 of stimulation. RESULTS: Serum-E2 levels on the hCG-day administration were significantly reduced in the Group-A. FF-VEGF levels were higher in Group-A. We did not find significant differences in the number of retrieved oocytes. The quality of oocytes proved to be higher and more significant from a statistical point of view in Group-B. The number of embryos obtained and transferred, the pregnancy rate lower in Group-A. CONCLUSIONS: In our study, it was shown that LH supplementation seems to have a beneficial effect on the maturity and fertilizability of oocyte. Lower FF VEGF levels, found in Group B, could be an indication of a lower apoptosis rate in human cumulus cells after administration of LH. We can affirm that LH-supplementation is beneficial in patients who show asignificant serum LH suppression during the receptorial down-regulation