%0 Journal Article
%T Effects of recombinant LH supplementation to recombinant FSH during induced ovarian stimulation in the GnRH-agonist protocol: a matched case-control study
%A Jos¨¦ G Franco
%A Ricardo LR Baruffi
%A JoŁżo Oliveira
%A Ana L Mauri
%A Claudia G Petersen
%A Paula Contart
%A Valeria Felipe
%J Reproductive Biology and Endocrinology
%D 2009
%I BioMed Central
%R 10.1186/1477-7827-7-58
%X A total of 244 patients without ovulatory dysfunction, aged <40 years and at the first ICSI cycle were divided into two groups matched by age according to an ovarian stimulation scheme: Group I (n = 122): Down-regulation with GnRH-a + r-FSH and Group II (n = 122): Down-regulation with GnRH-a + r-FSH and r-LH (beginning simultaneously).The number of oocytes collected, the number of oocytes in metaphase II and fertilization rate were significantly lower in the Group I than in Group II (P = 0.036, P = 0.0014 and P = 0.017, respectively). In addition, the mean number of embryos produced per cycle and the mean number of frozen embryos per cycle were statistically lower (P = 0.0092 and P = 0.0008, respectively) in Group I than in Group II. Finally the cumulative implantation rate (fresh+thaw ed embryos) was significantly lower (P = 0.04) in Group I than in Group II. The other clinical and laboratory results analyzed did not show difference between groups.These data support r-LH supplementation in ovarian stimulation protocols with r-FSH and GnRH-a for assisted reproduction treatment.The pharmacology of ovarian stimulation has been strongly influenced by the two-cell, two-gonadotrophin theory [1] while, historically, follicular stimulation protocols have included both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in an attempt to mimic normal physiology [2]. During recent years, the effect of LH on follicular maturation and pregnancy outcome during the course of ovarian stimulation in relation to assisted reproduction has received increasing attention. This interest reflects the fact that modern stimulation protocols have resulted in substantially lower LH concentrations than those observed in the natural cycle and in previously used protocols. The introduction of gonadotrophin-releasing hormone agonists (GnRH-a) in the mid-1980s successfully circumvented the problems of a premature LH surge. There has also been a gradual shift from human gonadotrophin (H
%U http://www.rbej.com/content/7/1/58