Mid-follicular LH supplementation in women aged 35–39 years undergoing ICSI cycles: a randomized controlled study

Matorras, R; Prieto, B; Exposito, A; Mendoza, R; Crisol, L; Herranz, P; Burgués, S

doi:10.1016/j.rbmo.2009.09.016

« Previous Next »Reproductive BioMedicine Online
Volume 19, Issue 6 , Pages 879-887, December 2009

Mid-follicular LH supplementation in women aged 35–39 years undergoing ICSI cycles: a randomized controlled study

R Matorras
- Department of Obstetrics and Gynecology, Hospital de Cruces, País Vasco University, Baracaldo, Vizcaya, Spain
- IVI Bilbao, Bilbao, Spain
- Correspondence:
B Prieto
- Department of Obstetrics and Gynecology, Hospital de Cruces, País Vasco University, Baracaldo, Vizcaya, Spain
A Exposito
- Department of Obstetrics and Gynecology, Hospital de Cruces, País Vasco University, Baracaldo, Vizcaya, Spain
R Mendoza
- Department of Obstetrics and Gynecology, Hospital de Cruces, País Vasco University, Baracaldo, Vizcaya, Spain
L Crisol
- Department of Obstetrics and Gynecology, Hospital de Cruces, País Vasco University, Baracaldo, Vizcaya, Spain
P Herranz
- Merck Farma y Química, SL, Madrid, Spain
S Burgués
- Merck Farma y Química, SL, Madrid, Spain

Received 10 February 2009; received in revised form 17 March 2009; accepted 6 July 2009. published online 02 August 2010.

Declaration: RM and BP have received investigational and educational grants, including grants for assistance to medical meetings, from Merck Serono, Ferring and Organon. AE and RM have received investigational and educational grants, including grants for assistance to medical meetings, from Merck Serono and Ferring. LC has received investigational and educational grants, including grants for assistance to medical meetings, from Merck Serono. PH and SB are employees of Merck Serono.

Abstract

This single-centre, randomized, parallel group, comparative study aimed to identify potential benefits of mid-follicular recombinant human LH (r-HLH) supplementation in women aged 35–39years undergoing ovarian stimulation for intracytoplasmic sperm injection (ICSI). The main endpoint was the number of metaphase II oocytes retrieved. After pituitary suppression with a gonadotrophin-releasing hormone agonist, ovarian stimulation was initiated with recombinant human FSH (r-HFSH; 300–450IU/day). On stimulation day 6, patients were randomized to receive r-HFSH alone or r-HFSH+r-HLH (r-HLH 150IU/day) for the remainder of the stimulation period. Final follicular maturation was triggered with 250μg of recombinant human chorionic gonadotrophin. After assessing oocyte nuclear maturity, oocyte were fertilized by ICSI and afterwards embryo quality was analyzed. Of the 131 women enrolled, 68 were allocated to r-HFSH alone and 63 to r-HFSH+r-HLH. No significant differences were observed in markers of either oocyte or embryo quality or quantity. However, higher rates of implantation and live birth per started cycle were observed with r-HLH supplementation than with r-HFSH alone. Although additional large studies are required to further investigate these findings, r-HLH supplementation for women aged 35–39years undergoing ICSI is recommended as it may have a beneficial action on implantation.

Keywords: ICSI, implantation, metaphase II, pregnancy, r-HFSH, r-HLH

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Roberto Matorras, MD, PhD is Chairman of Obstetrics and Gynecology of the Basque Country University, Head of the Human Reproductive Unit of the Cruces Hospital (Vizcaya, Spain), and Scientific Director of the Clinic IVI-Bilbao, Spain. He is author of 400 scientific articles, 80 of them in peer-reviewed journals. He is a past President of the Spanish Society of Infertility. His main interest areas are IVF, endometriosis, and intrauterine insemination. Dr Roberto Matorras