Einstein (São Paulo) (Jun 2005)
The effect of recombinant human luteinizing hormone on oocyte/embryo quality and treatment outcome in down-regulated women undergoing in vitro fertilization
Abstract
Objective: To compare oocyte/embryo quality and treatmentoutcome in patients undergoing IVF/ICSI using recombinantluteinizing hormone (rhLH) or human menopausal gonadotrophin(hMG) as a supplement to recombinant follicle-stimulating hormone(rhFSH) during ovarian stimulation. Methods: After pituitarydesensitization, sixty women undergoing their first IVF treatmentcycle were randomized to receive a fixed daily dose of either rhFSH(225 IU/d) plus hMG (75 IU/d) (group A, n=30) or rhLH (75 IU/d)(group B, n=30). The number/quality of metaphase II (MII) oocytes,zygote/embryo quality, and clinical pregnancy/implantation rateswere compared between the two groups. Results: The mean numberof normal/abnormal MII oocytes was 4.5±3.10/2.8±3.13 in groupA and 2.4±1.47/4.0±3.70 in group B, showing a significantdifference between groups (p=0.006; p=0.01; respectively). Thefertilization rate was similar in both groups, yet the number ofzygotes judged normal was significantly higher (p= 0.02) in groupA (2.4±2.40) as compared to group B (1.2±1.76). The mean numberand quality score of embryos at transfer were similar in both groups.Overall clinical pregnancy/implantation rates were 46.4%/25.3%in group A and 38.1%/17.1% in group B. The trend toward betterpregnancy outcomes among patients in group A did not reachstatistical significance. Conclusions: Our study suggests that theaddition of recombinant luteinizing hormone instead of humanmenopausal gonadotrophin to recombinant follicle-stimulatinghormone throughout ovulation induction in down-regulated womenundergoing IVF does not improve ovarian response and has anegative impact on oocyte/zygote quality. The result is a trendtoward poorer treatment outcome.
