補充低劑量hCG可提高低LH病患懷孕率

使用腦下垂體拮抗劑病患，若體內LH濃度低於 0.5 mIU/mL，適量注射低劑量hCG，可提高著床率 (54% vs. 19%) 與活產率(64% vs. 25%)

from: http://www.ncbi.nlm.nih.gov/pubmed/21839437

Fertil Steril. 2011 Oct;96(4):898-904. Epub 2011 Aug 11.

Low-dose human chorionic gonadotropin may improve in vitro fertilization cycle outcomes in patients with low luteinizing hormone levels after gonadotropin-releasing hormone antagonist administration.

Propst AM, Hill MJ, Bates GW, Palumbo M, Van Horne AK, Retzloff MG.

Source

Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA. anthony.propst@usuhs.mil

Abstract

OBJECTIVE:

To evaluate the effect of low levels of endogenous luteinizing hormone (LH) and low-dose human chorionic gonadotropin (hCG) supplementation on in vitro fertilization (IVF) cycle outcomes in a gonadotropin-releasing hormone (GnRH) antagonist protocol.

INTERVENTION(S):

Addition of low-dose urinary hCG to IVF stimulations using a recombinant follicle-stimulating hormone (FSH) and GnRH antagonist protocol.

MAIN OUTCOME MEASURE(S):

Implantation and live-birth rates.

RESULT(S):

As part of a larger cohort of 239 patients, 42 patients with LH levels ≤ 0.5 mIU/mL were evaluated. In the larger cohort, there were no differences in implantation and pregnancy rates between the recombinant FSH only (n = 113) and the recombinant FSH with low-dose hCG supplementation (n = 126) groups. In the FSH-only group, patients with LH levels ≤ 0.5 mIU/mL had decreased implantation rates (19% vs. 42%) and live-birth rates (25% vs. 54%) as compared with patients with LH levels >0.5 mIU/mL. Low LH patients in the recombinant FSH with low-dose urinary hCG group had statistically significantly higher implantation rates (54% vs. 19%) and live-birth rates (64% vs. 25%) as compared with patients with similar low LH levels in the recombinant FSH-only group.

CONCLUSION(S):

Endogenous LH levels ≤ 0.5 mIU/mL after GnRH antagonist treatment are associated with statistically significantly lower implantation and pregnancy rates in recombinant FSH-only cycles. The addition of low-dose urinary hCG results in improved implantation and live-birth rates in patients with low LH levels.