The effect of rLH supplementation to the GnRH-antagonist protocol on endocrine dynamics in the advanced reproductive age

J. S. Younis, I. Izhaki, M. Ben-Ami

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To explore serum endocrine dynamics, specifically LH levels, following rLH supplementation to rFSH following GnRH-antagonist treatment in the advance reproductive age. Methods: Women were prospectively and similarly treated employing rFSH and the flexible GnRH-antagonist protocol, while rLH was supplemented only to the study group. Serum FSH, LH, E2, and P were evaluated throughout the follicular phase. Three strategies were a priori planned to examine endocrine dynamics among women enrolled. Results: While serum LH drop were similar before GnRH-antagonist stimulation, it dropped more times in the control group compared to the study group. Among women receiving rFSH only, serum LH levels dropped ≤2, ≤1 and ≤0.5 mIU/mL in 71.4, 46.4, and 28.6% of cases, while this occurred only in 38.7% (P = 0.01), 6.5% (P = 0.0004) and 3.2% (P = 0.007) of women receiving combined rFSH and rLH treatment, respectively. The same trend was found when serum LH dropped in at least two occasions following the GnRH-antagonist administration. Conversely, serum LH diagrams throughout the follicular phase did not differ between the two groups. Furthermore, individual area under the curve values of LH, E2, and P was similar between the two groups following GnRH-antagonist initiation. Conclusions: Different strategies to explore LH dynamics following the GnRH-antagonist administration have resulted in diverse results, implying the need for a consensus definition of LH threshold for adequate folliculogenesis and steroidogenesis. Such action would pave the way for understanding which groups of patients may benefit from rLH supplementation.

Original languageEnglish
Pages (from-to)831-839
Number of pages9
JournalJournal of Endocrinological Investigation
Volume40
Issue number8
DOIs
StatePublished - 1 Aug 2017

Bibliographical note

Publisher Copyright:
© 2017, Italian Society of Endocrinology (SIE).

Keywords

  • Assisted reproductive technologies
  • LH threshold
  • Ovarian steroidogenesis
  • Serum LH dynamics

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

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