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      Comparison of the Administration of 150 or 75 IU of Recombinant LH in Agonist ICSI Cycles Stimulated with Recombinant FSH in Women Aged 35–39: A Comparative Study

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          Abstract

          Background:

          The purpose of the study was to assess whether the coadministration of 150 IU of recombinant LH instead of 75 IU in women aged 35–39 improves the results in agonist ICSI cycles stimulated with 300 IU of recombinant FSH.

          Methods:

          In this study, two ovarian stimulation protocols coexisted which were identical except in the administered dose of recombinant LH, for which some patients received 150 IU (n=231) and some received 75 IU (n=216). Both groups received 300 IU of recombinant FSH. Gonadotropins were reimbursed by the National Health System. Statistical analysis was performed by Student’s t test, χ 2, and ANCOVA. Significance level was established at p=0.05.

          Results:

          The number of retrieved oocytes was slightly higher in the 300/150 group (9.06±5.53 vs. 8.61±5.11), but the differences were not significant. Results were similar with the number of metaphase II oocytes (7.18±4.86 vs. 6.72±4.72) and the number of fertilized oocytes (4.64±3.2 vs. 4.23±2.72). The per-transfer clinical pregnancy rates exhibited close similarity between both groups (32.84% vs. 32.46%), as did the per-transfer live birth rates (29.90% vs. 30.37%) and the implantation rate. The rate of hyperstimulation syndrome (OHSS) as well as the rate of cancellation due to OHHS risk was similar in both groups. There was also no difference in the miscarriage rate. When results were expressed by per started cycle or by oocyte pick-up, the results remained very similar in both groups.

          Conclusion:

          In women aged 35–39 undergoing ovarian stimulation with recombinant FSH in agonist cycles, the coadministration of 75 or 150 UI of recombinant LH did not influence pregnancy rates. However, a slight increase in the number of retrieved oocytes should not be disregarded.

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          Most cited references37

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          Luteal phase support for assisted reproduction cycles.

          Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin(hCG) produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques(ART), progesterone and/or hCG levels are low, so the luteal phase is supported with progesterone, hCG or gonadotropin-releasing hormone (GnRH) agonists to improve implantation and pregnancy rates.
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            • Record: found
            • Abstract: found
            • Article: not found

            Adjuvant treatment strategies in ovarian stimulation for poor responders undergoing IVF: a systematic review and network meta-analysis.

            Despite great advances in assisted reproductive technology, poor ovarian response (POR) is still considered as one of the most challenging tasks in reproductive medicine.
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              • Record: found
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              Current concepts of the roles of follicle stimulating hormone and luteinizing hormone in folliculogenesis.

              Around 400 follicles sequentially mature and ovulate during an average woman's reproductive lifetime. From birth to the menopause, the other approximately 99.98% of her follicles begin development but never complete it. Instead they default to atresia due to inadequate stimulation by follicle stimulating hormone (FSH). Follicular growth to the stage of antrum formation (approximately 0.25 mm diameter) is independent of gonadotrophic stimulation. Antrum formation and further growth to the stage at which follicles become potentially able to begin preovulatory development (2-5 mm diameter) require tonic stimulation by FSH. Before onset of puberty, blood concentrations of FSH do not rise sufficiently to sustain development beyond this stage, therefore all antral follicles become atretic. After puberty, as each menstrual cycle begins, FSH concentrations rise beyond a critical 'threshold' and multiple follicles are recruited to begin pre-ovulatory development. Due to increases in its responsiveness to FSH and luteinizing hormone (LH), one of these follicles becomes selected to ovulate while the remainder become atretic. At mid-follicular phase, the dominant follicle reaches > or = 10 mm in diameter and increasingly synthesizes oestradiol. Tonic stimulation by FSH and LH, underpinned by local paracrine signalling, maintains oestrogen secretion by the dominant follicle, which grows to > or = 20 mm in diameter before it ovulates in response to the mid-cycle LH surge. The development-related response to LH shown by the pre-ovulatory follicle raises the possibility that exogenous LH might be used as an adjunct to therapy with exogenous FSH in clinical ovulation induction regimens where the aim is to induce monovulation.
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                Author and article information

                Journal
                J Reprod Infertil
                J Reprod Infertil
                JRI
                Journal of Reproduction & Infertility
                Avicenna Research Institute
                2228-5482
                2251-676X
                Oct-Dec 2023
                : 24
                : 4
                : 269-278
                Affiliations
                [1- ] Human Reproduction Unit, Cruces University Hospital, Barakaldo, Spain
                [2- ] Faculty of Medicine, University of the Basque Country, Bizkaia, Spain
                [3- ] Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
                [4- ] Instituto Valenciano de Infertilidad (IVI) Bilbao, Leioa, Spain
                [5- ] Department of Mathematics, Faculty of Science and Technology, University of the Basque Country, Bizkaia, Spain
                Author notes
                [* ] Corresponding Author: Alberto Vendrell, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain, E-mail: alberto.venber@ 123456gmail.com
                Article
                JRI-24-269
                10.18502/jri.v24i4.14154
                10757692
                903baa57-734a-4a77-8509-fd8a0c2c454d
                Copyright© 2023, Avicenna Research Institute.

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license. ( https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited

                History
                : 24 May 2023
                : 24 October 2023
                Categories
                Original Article

                agonist icsi cycles,coadministration,luteinizing hormone,oocyte,ovarian stimulation,pregnancy rate

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