Reproductive Biology and Endocrinology (Feb 2019)

The role of recombinant LH in women with hypo-response to controlled ovarian stimulation: a systematic review and meta-analysis

  • Alessandro Conforti,
  • Sandro C. Esteves,
  • Francesca Di Rella,
  • Ida Strina,
  • Pasquale De Rosa,
  • Alessia Fiorenza,
  • Fulvio Zullo,
  • Giuseppe De Placido,
  • Carlo Alviggi

DOI
https://doi.org/10.1186/s12958-019-0460-4
Journal volume & issue
Vol. 17, no. 1
pp. 1 – 12

Abstract

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Abstract Objective To study the role of recombinant human LH supplementation in women with hypo-response to ovarian stimulation. Methods We performed a systematic review and meta-analysis of prospective clinical trials in which recombinant FSH monotherapy protocols were compared with LH-supplemented protocols in hypo-responders. A search was conducted of the Scopus, MEDLINE databases without time or language restrictions. Primary outcome was clinical pregnancy rate. Results Significantly higher clinical pregnancy rates (odds ratio: 2.03, P = 0.003), implantation rates (odds ratio: 2.62, P = 0.004) and number of oocytes retrieved (weight mean differences: 1.98, P = 0.03) were observed in hypo-responders supplemented with recombinant LH versus hypo-responders who underwent FSH monotherapy. No differences in terms of mature oocytes or miscarriage rates were found between the two groups. Conclusion In conclusion, our analysis confirms that women with a hypo-response to exogenous gonadotropins might benefit from LH supplementation. However, more trials are required before a definitive conclusion can be drawn.

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