誘導排卵施打LH對一般試管嬰兒並無明顯助益

誘導排卵晚期施打LH對一般試管嬰兒懷孕率並無明顯助益

誘導排卵施打LH可能只對特定病患(e.g.高齡)有益‧

http://humrep.oxfordjournals.org/content/21/1/90.full

The use of recombinant human LH (lutropin alfa) in the late stimulation phase of assisted reproduction cycles: a double-blind, randomized, prospective study

1. B. Tarlatzis ⁴ , ⁷ , 
2. E. Tavmergen ⁵ , 
3. M. Szamatowicz ⁶ , 
4. A. Barash ¹ , 
5. A. Amit² , 
6. E. Levitas ³ and 
7. Z. Shoham ¹

+Author Affiliations

1. ¹Kaplan Medical Centre, Division of Infertility, In vitro Fertilization Unit, Department of Obstetrics and Gynecology, Rehovot 76100, ²Tel Aviv Medical Centre, Ein Dor 15, Hakyria 61070 and ³Soroka Medical Centre, IVF Unit, Beer-Sheva, Israel, ⁴Unit for Human Reproduction, Aristotle University of Thessaloniki and Infertility & IVF Centre, Geniki Kliniki, Thessaloníki, Greece, ⁵Ege University Family Planning – Infertility (IVF) Research and Treatment Centre, Bornova, Izmir, Turkey, and ⁶Institute of Obstetrics and Gynaecology, Medical Academy of Bialystok, 15–276 Bialystok, Poland

1. 7To whom correspondence should be addressed. E-mail: tarlatzis@hol.gr

• Received August 13, 2004.
• Revision received June 14, 2005.
• Accepted June 24, 2005.

 

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Abstract

BACKGROUND: The effect of recombinant human LH (r-hLH; lutropin alfa) in women undergoing controlled ovarian stimulation with recombinant human FSH (r-hFSH) prior to IVF was investigated. METHODS: After down-regulation with the GnRH agonist, buserelin, 114 normo-ovulatory women (aged 18–37 years) received r-hFSH alone until the lead follicle reached a diameter of 14 mm. Patients were then randomized in a double-blind fashion to receive r-hFSH in addition to r-hLH, 75 IU s.c., or placebo daily for a maximum of 10 days prior to oocyte retrieval and IVF. The primary end-point was the number of metaphase II oocytes. RESULTS: There were no significant differences between treatment groups for the primary end-point. Serum estradiol concentrations on the day of HCG administration were significantly higher in the group receiving r-hLH plus r-hFSH than in the group receiving r‐hFSH alone (P = 0.0001), but there were no significant differences between the groups in dose and duration of r‐hFSH treatment required, oocyte maturation, fertilization rate, pregnancy rate and live birth rate. CONCLUSION: In this patient population, the addition of r-hLH during the late follicular phase of a long GnRH agonist and r-hFSH stimulation cycle provides no further benefit in terms of oocyte maturation or other end-points.

Table III.

Pregnancy outcome characteristics of the two treatment groups

	r-hFSH plus placebo	r-hFSH plus r-hLH
Number of patients with retrieved oocytes	57	55
Number of oocytes retrieved	9.8 ± 7.0	10.1 ± 5.4
Number of patients undergoing ICSI	52	47
Number of MII oocytes retrieved a	6.2 ± 4.8	6.9 ± 4.9
Number of two pronuclei oocytes b	5.0 ± 3.8	5.6 ± 3.5
Number of embryos transferred b	2.9 ± 1.5	3.2 ± 1.5
Number of viable pregnancies (%/cycle)	14 (23.7%) c	9 (16.4%)
Number of miscarriages (%/pregnancy)	4 (28.6%)	3 (33.3%)
Number of patients giving birth (% live birth rate)	10 (16.9%)*	6 (10.9%)
Number of live births	16	8