Volume 16, Issue 3 (3-2018)                   IJRM 2018, 16(3): 175-182 | Back to browse issues page

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Depalo R, Trerotoli P, Chincoli A, Vacca M P, Lamanna G, Cicinelli E. Endogenous luteinizing hormone concentration and IVF outcome during ovarian stimulation in fixed versus flexible GnRH antagonist protocols: An RCT. IJRM. 2018; 16 (3) :175-182
URL: http://journals.ssu.ac.ir/ijrmnew/article-1-1029-en.html
1- Department of Obstetrics-Gynecology-Neonatology and Anesthesiology, Unit of Medically Assisted Reproduction and Gametes Cryopreservation, University Hospital of Bari, Bari, Italy.
2- Department of Biomedical and Human Oncological Science (DIMO), 2nd Unit of Obstetrics and Gynecology, University of Bari, Bari, Italy
3- Department of Obstetrics-Gynecology-Neonatology and Anesthesiology, Unit of Medically Assisted Reproduction and Gametes Cryopreservation, University Hospital of Bari, Bari, Italy , annarosa.chincoli@virgilio.it
4- Department of Obstetrics-Gynecology-Neonatology and Anesthesiology, Unit of Medically Assisted Reproduction and Gametes Cryopreservation, University Hospital of Bari, Bari, Italy
5- Consultant Gynaecologist and IVF Specialist, London Women's Clinic, London, UK
Abstract:   (125 Views)
Background: Luteinizing hormone (LH) is essential for normal follicular development and oocyte maturation. In particular, fluctuations of LH during the follicular phase have a significant impact on morphological and functional changes of the oocyte and determine its meiotic status and ability to be fertilized.
Objective: This prospective randomized controlled trial examined effects of endogenous follicular phase LH levels on oocyte maturity and IVF outcomes in fixed vs. flexible in vitro fertilization.
Materials and Methods: Normo-ovulatory women age <39 yr (n=213) were randomized to fixed or flexible gonadotrophin-releasing hormone (GnRH) antagonist protocols. Follicular phase LH, estradiol, and progesterone profiles were measured. Oocytes retrieved, implantation rate, and pregnancy rate were compared between the two groups.
Results: LH profiles were similar in both protocols. A lower trend of LH values at the end of ovarian stimulation correlated significantly with a higher pregnancy rate, regardless of protocol (p=0.02). Estradiol levels were statistically different with respect to time points within treatment groups (p<0.0001), but not between groups (p=0.43), or pregnancy outcomes (p=0.2595). Progesterone profiles were similar between groups. No differences were found in retrieved oocytes numbers, fertilization rate or embryos obtained. Significantly, younger age and a higher number of antral follicles were correlated with positive results.
Conclusion: Fixed and flexible GnRH antagonist protocols did not produce an oscillation of endogenous LH values correlated to the outcome of ovarian stimulation.
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Type of Study: Original Article |
Received: 2018/04/12 | Accepted: 2018/04/12 | Published: 2018/04/12

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