Recombinant follicle-stimulating hormone versus human menopausal gonadotropin in the late follicular phase during ovarian hyperstimulation for in vitro fertilization

Objective: To study the effect of exogenous LH in the late follicular phase on ongoing pregnancies and at the different stages of IVF-ET (stimulation, fertilization, and implantation) in patients with low endogenous LH. Design: Retrospective cohort study with modeling of the different phases of IVF-ET. Setting: IVF center of the teaching hospital in Bordeaux, France. Patient(s): Women undergoing IVF and ICSI treatment. Intervention(s): One group received recombinant FSH alone (FSH group) and the other received recombinant FSH and hMG in the late follicular phase (i.e., when the largest follicle reached 14 mm) (FSH/hMG group). Main Outcome Measure(s): Ongoing pregnancy, number of oocytes, and number of embryos. Result(s): The FSH/hMG group had a higher probability of having at least one oocyte (odds ratio [OR] 2.75 [1.11-6.80]), of having at least one embryo after oocyte retrieval (OR = 2.84 [1.33-6.07]), and of ongoing pregnancy after ET (OR = 2.04 [0.83-5.01]), and globally had a higher probability of ongoing pregnancy (OR = 2.83 [1.19-6.71]). Conclusion(s): In ovarian hyperstimulation for IVF-ET, LH supplementation in the late follicular phase of women with low endogenous LH is beneficial for ongoing pregnancy by increasing the rate of success of all stages of the treatment.