International Journal of Reproductive BioMedicine
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences of Yazd
Vol. 16, No. 3, 2018, pp. 175-182
Bioline Code: rm18020
Full paper language: English
Document type: Research Article
Document available free of charge
International Journal of Reproductive BioMedicine, Vol. 16, No. 3, 2018, pp. 175-182
© Copyright 2018 - International Journal of Reproductive BioMedicine
Endogenous luteinizing hormone concentration and IVF outcome during ovarian stimulation in fixed versus flexible GnRH antagonist protocols: An RCT|
Depalo, Raffaella; Trerotoli, Paolo; Chincoli, Annarosa; Vacca, Margherita Patrizia; Lamanna, Giuseppina & Cicinelli, Ettore
Background: Luteinizing hormone (LH) is essential for normal follicular
development and oocyte maturation. In particular, fluctuations of LH during the
follicular phase have a significant impact on morphological and functional changes
of the oocyte and determine its meiotic status and ability to be fertilized.
Objective: This prospective randomized controlled trial examined effects of
endogenous follicular phase LH levels on oocyte maturity and IVF outcomes in
fixed vs. flexible in vitro fertilization.
Materials and Methods: Normo-ovulatory women age <39 yr (n=213) were
randomized to fixed or flexible gonadotrophin-releasing hormone (GnRH)
antagonist protocols. Follicular phase LH, estradiol, and progesterone profiles were
measured. Oocytes retrieved, implantation rate, and pregnancy rate were compared
between the two groups.
Results: LH profiles were similar in both protocols. A lower trend of LH values at
the end of ovarian stimulation correlated significantly with a higher pregnancy rate,
regardless of protocol (p=0.02). Estradiol levels were statistically different with
respect to time points within treatment groups (p<0.0001), but not between groups
(p=0.43), or pregnancy outcomes (p=0.2595). Progesterone profiles were similar
between groups. No differences were found in retrieved oocytes numbers,
fertilization rate or embryos obtained. Significantly, younger age and a higher
number of antral follicles were correlated with positive results.
Conclusion: Fixed and flexible GnRH antagonist protocols did not produce an
oscillation of endogenous LH values correlated to the outcome of ovarian
In vitro fertilization; Luteinizing hormone; Ovarian stimulation; Outcome.
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