A retrospective, matched case-control study of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol
BackgroundThe role of luteinizing hormone (LH) in controlled ovarian hyperstimulation (COH) requires more evidence for its efficacy. Several studies compared recombinant human LH (r-hLH) or human menopausal gonadotropin (hMG) in combination with recombinant human follicle-stimulating hormone (r-hFSH...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.931756/full |
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| author | Ming-Jer Chen Ming-Jer Chen Yu-Chiao Yi Yu-Chiao Yi Hwa-Fen Guu Ya-Fang Chen Hsiao-Fan Kung Jui-Chun Chang Shih-Ting Chuan Li-Yu Chen |
| author_facet | Ming-Jer Chen Ming-Jer Chen Yu-Chiao Yi Yu-Chiao Yi Hwa-Fen Guu Ya-Fang Chen Hsiao-Fan Kung Jui-Chun Chang Shih-Ting Chuan Li-Yu Chen |
| author_sort | Ming-Jer Chen |
| collection | DOAJ |
| description | BackgroundThe role of luteinizing hormone (LH) in controlled ovarian hyperstimulation (COH) requires more evidence for its efficacy. Several studies compared recombinant human LH (r-hLH) or human menopausal gonadotropin (hMG) in combination with recombinant human follicle-stimulating hormone (r-hFSH) but lack the results with GnRH-antagonist protocol and in Asians.MethodsThis is a retrospective, single-center study inspecting women receiving GnRH antagonist protocol and r-hFSH+hMG or r-hFSH+r-hLH regimen for over five days for COH in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle in Taiwan from 2013 to 2018. The outcomes of IVF/ICSI cycles were analyzed after propensity score matching between the two groups. A subgroup analysis was conducted in cycles in which women underwent their first embryo transfer (ET), including fresh ET and frozen ET (FET).ResultsWith a total of 503 cycles, the results revealed that the r-hFSH+r-hLH group performed better in terms of numbers of oocytes retrieved (r-hFSH+hMG vs. r-hFSH+r-hLH, 11.7 vs. 13.7, p=0.014), mature oocytes (8.7 vs. 10.9, p=0.001), and fertilized oocytes (8.3 vs. 9.8, p=0.022), while other outcomes were comparable. The analysis of first ET cycles also showed similar trends. Although the implantation rate (39% vs. 43%, p=0.37), pregnancy rate (52% vs. 53%, p=0.90), and live birth rate (39% vs. 45%, p=0.19) were not significantly different, the miscarriage rate was higher in the r-hFSH+hMG group than the r-hFSH+r-hLH group (26% vs. 15%, p<0.05) in first ET cycles. The cumulative live birth rate was significantly higher in the r-hFSH+r-hLH group (53% vs. 64%, p=0.02). No significant difference in rates of ovarian hyperstimulation syndrome (OHSS) was observed.ConclusionThe results support the hypothesis that the treatment of r-hLH+r-hFSH improves COH clinical outcomes in the IVF/ICSI cycle. |
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| issn | 1664-2392 |
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| last_indexed | 2024-04-12T04:46:26Z |
| publishDate | 2022-08-01 |
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| spelling | doaj.art-0e2f096f5dac438cb7c0a6f90936c6ff2022-12-22T03:47:28ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-08-011310.3389/fendo.2022.931756931756A retrospective, matched case-control study of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocolMing-Jer Chen0Ming-Jer Chen1Yu-Chiao Yi2Yu-Chiao Yi3Hwa-Fen Guu4Ya-Fang Chen5Hsiao-Fan Kung6Jui-Chun Chang7Shih-Ting Chuan8Li-Yu Chen9Department of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, TaiwanBackgroundThe role of luteinizing hormone (LH) in controlled ovarian hyperstimulation (COH) requires more evidence for its efficacy. Several studies compared recombinant human LH (r-hLH) or human menopausal gonadotropin (hMG) in combination with recombinant human follicle-stimulating hormone (r-hFSH) but lack the results with GnRH-antagonist protocol and in Asians.MethodsThis is a retrospective, single-center study inspecting women receiving GnRH antagonist protocol and r-hFSH+hMG or r-hFSH+r-hLH regimen for over five days for COH in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle in Taiwan from 2013 to 2018. The outcomes of IVF/ICSI cycles were analyzed after propensity score matching between the two groups. A subgroup analysis was conducted in cycles in which women underwent their first embryo transfer (ET), including fresh ET and frozen ET (FET).ResultsWith a total of 503 cycles, the results revealed that the r-hFSH+r-hLH group performed better in terms of numbers of oocytes retrieved (r-hFSH+hMG vs. r-hFSH+r-hLH, 11.7 vs. 13.7, p=0.014), mature oocytes (8.7 vs. 10.9, p=0.001), and fertilized oocytes (8.3 vs. 9.8, p=0.022), while other outcomes were comparable. The analysis of first ET cycles also showed similar trends. Although the implantation rate (39% vs. 43%, p=0.37), pregnancy rate (52% vs. 53%, p=0.90), and live birth rate (39% vs. 45%, p=0.19) were not significantly different, the miscarriage rate was higher in the r-hFSH+hMG group than the r-hFSH+r-hLH group (26% vs. 15%, p<0.05) in first ET cycles. The cumulative live birth rate was significantly higher in the r-hFSH+r-hLH group (53% vs. 64%, p=0.02). No significant difference in rates of ovarian hyperstimulation syndrome (OHSS) was observed.ConclusionThe results support the hypothesis that the treatment of r-hLH+r-hFSH improves COH clinical outcomes in the IVF/ICSI cycle.https://www.frontiersin.org/articles/10.3389/fendo.2022.931756/fullcontrolled ovarian hyperstimulationrecombinant FSHrecombinant LHhuman menopausal gonadotrophin (hMG)pregnancy |
| spellingShingle | Ming-Jer Chen Ming-Jer Chen Yu-Chiao Yi Yu-Chiao Yi Hwa-Fen Guu Ya-Fang Chen Hsiao-Fan Kung Jui-Chun Chang Shih-Ting Chuan Li-Yu Chen A retrospective, matched case-control study of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol Frontiers in Endocrinology controlled ovarian hyperstimulation recombinant FSH recombinant LH human menopausal gonadotrophin (hMG) pregnancy |
| title | A retrospective, matched case-control study of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol |
| title_full | A retrospective, matched case-control study of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol |
| title_fullStr | A retrospective, matched case-control study of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol |
| title_full_unstemmed | A retrospective, matched case-control study of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol |
| title_short | A retrospective, matched case-control study of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol |
| title_sort | retrospective matched case control study of recombinant lh versus hmg supplementation on fsh during controlled ovarian hyperstimulation in the gnrh antagonist protocol |
| topic | controlled ovarian hyperstimulation recombinant FSH recombinant LH human menopausal gonadotrophin (hMG) pregnancy |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.931756/full |
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