Recombinant Follicular Stimulating Hormone Plus Recombinant Luteinizing Hormone Versus Human Menopausal Gonadotropins- Does the Source of LH Bioactivity Affect Ovarian Stimulation Outcome?
The study found that using recombinant LH in IVF cycles resulted in a higher mean number of mature and fertilized oocytes compared to using highly purified hMG, but no differences in pregnancy rates were observed.
Where it sits
this study against the rest of the hmg (human menopausal gonadotropin) corpusSummary and findings
This study measured the impact of different sources of luteinizing hormone (LH) on ovarian stimulation outcomes in patients undergoing IVF. Two consecutive cycles were compared: one using recombinant follicular stimulating hormone (FSH) plus recombinant LH and the other using highly purified human menopausal gonadotropin (HP-hMG). The results indicated a higher mean number of mature oocytes and fertilized oocytes in the recombinant LH group.
Abstract
<title>Abstract</title> <p><bold>Background:</bold> Luteinizing hormone (LH) and human chorionic gonadotropin (hCG) activate distinct intracellular signaling cascades. However, due to their similar structure and common receptor, they are used interchangeably during ovarian stimulation (OS). This study aims to assess if the source of LH used during OS affects IVF outcome. <bold>Materials and methods:</bold> This was a cross sectional study of patients who underwent two consecutive IVF cycles, one included recombinant follicular stimulating hormone (FSH) plus recombinant LH [rFSH+rLH, (Pergoveris)] and the other included urinary hCG [highly purified hMG (HP-hMG), (Menopur)]. The OS protocol, except of the LH preparation, was identical in the two IVF cycles. <bold>Results:</bold> The rate of mature oocytes was not different between the treatment cycles (0.9 in the rFSH+rLH vs 0.8 in the HP-hMG, p=0.07). Nonetheless, the mean number of mature oocytes retrieved in the rFSH+rLH treatment cycles was higher compared to the HP-hMG treatment cycles (10 ± 5.8 vs 8.3 ±4.6, respectively, P=0.01). Likewise, the mean number of fertilized oocytes was higher in the rFSH+rLH cycles compared with the HP-hMG cycles (8.5 ± 5.9 vs 6.4 ± 3.6, respectively, p=0.05). There was no difference between the treatment cycles regarding the number of top-quality embryos, the ratio of top-quality embryos per number of oocytes retrieved or fertilized oocytes or the pregnancy rate. <bold>Conclusion:</bold> The differences in treatment outcome, derived by different LH preparations reflect the distinct physiological role of these molecules. Our findings may assist in tailoring a specific GT regimen when assembling an OS protocol.</p>