5.Once again: Controlled ovarian hyperstimulation with FSH alone or in combination with LH and with what dosage?
Recent data indicate that in controlled ovarian hyperstimulation the use of FSH alone is not superior over the use of FSH combined with LH as present in HMG preparations. One of these recent studies was performed to determine the effect of exogenous LH dosage on IVF outcome. Dose and duration of gonadotropin stimulation, follicle and oocyte numbers, implantation rate, and pregnancy rate were studies in four groups of women who received either FSH alone or in combination with LH at a dose of 1, 25 and 75 IU of LH per ampoule. The median duration of ovarian stimulation; median number of gonadotropin ampoules used, serum E2 levels, and numbers of follicles, oocytes, and embryos were similar among the four groups. Median LH levels on the day of hCG administration, however, differed significantly. Live birth rates per cycle differed markedly, but statistical significance was not achieved (23 %, 7 %, 20 %, and 31 % for groups 0, 1, 25, and 75, respectively). A significant trend in implantation rates was noted with increasing LH dosage of the urinary preparations (19 %, 10 %, 18 %, and 28 % for groups 0, 1, 25, and 75, respectively). Although, in this study, the residual endogenous LH after down-regulation was adequate for ovarian response and E2 synthesis, the addition of exogenous LH improved implantation. An FSH/LH ratio of 75/75 IU per ampule appeared to be the optimum dose.
Fillicori M, Cognigni, GE, Taraborrelli S, Spettoli D, Ciampaglia W, Tabarelli de Fatis C, Pocognoli P, Cantelli B, Bosch S (2001) Luteinizing hormone activity in menotropins optimizes folliculogenesis and treatment in controlled ovarian stimulation. J. Clin. Endocrinol. Metab. 86: 337-343
Gordon DU, Harrison AF, Fawzy M, Hennelly B, Gordon AC (2001) A randomized prospective assessor-blind evaluation of luteinizing hormone dosage and in fitro fertilization outcome. Fertil. Steril. 75: 324-331
Strehler E, Abt M, El-Danasouri I, De Santo M, Sterzik K (2001) Impact of recombinant follicle-stimulating hormone and human menopausal gonadotropins on in vitro fertilization outcome. Fertil. Steril. 75: 332-341
Ng EHY, Lau EYL, Yeung WSB, Ho PC (2001) HMG is as good as recombinant human FSH in terms of oocyte and embryo quality: a prospective and randomized trial. Hum. Reprod. 16: 319-325