A Comparison of Outcomes from IVF Cycles Stimulated with either Recombinant Luteinizing Hormone or Human Menopausal Gonadotropins in Subjects Treated with Long Gonadotropin Releasing Hormone Agonist Protocols, a Retrospective Analysis.

Objective The objective of this study is to compare rates of pregnancy and IVF parameters in subjects who were stimulated with follicle stimulating hormone (FSH) plus either recombinant human luteinizing hormone (r-LH) or human menopausal gonadotropins (hMG), in long gonadotropin releasing hormone (GnRH) agonist IVF protocols. MaterialsAndMethods This is a cohort study of patients undergoing IVF stimulation with a long GnRH agonist protocol that received FSH and r-LH or hMG. Outcomes measured were FSH and LH dose, number of oocytes and embryos obtained, pregnancy rate per cycle and clinical pregnancy rate per cycle. Stepwise logistic regression was performed on continuous and categorical variables to control for confounding effects between all variables analyzed. Results 122 patients that underwent 122 cycles of IVF with long GnRH agonist protocols were studied. Baseline parameters were similar between both groups. The FSH dose (3207±1300 vs. 4213±1576IU, p=0.0001) and the LH dose (1332±587 vs. 1938±1110IU, p=0.0001) required for stimulation were lower with r-LH, while number of days of stimulation did not differ (p=1.0). The number of oocytes (14.4±6.3 vs. 11.0±5.3) and embryos (7.9±4.8 vs. 6.0±3.7) were statistically higher with r-LH. Pregnancy rates per cycle start were higher for patients in the r-LH when compared to the hMG group (49% vs. 27%, p=0.025) as were implantation rates (62% vs. 33%, p=0.001). Clinical pregnancy rates per cycle start between r-LH and hMG trended higher (39% vs. 25%, p=0.065). Conclusion r-LH may offer benefit when compared to hMG when combined with FSH, for ovarian stimulation in long GnRH agonist protocols performed in good responders. Prospective studies should be undertaken to confirm these results.