What question did this study set out to answer?

To determine the effect of trigger-day luteinizing hormone levels on IVF pregnancy outcomes in different protocols and the role of age.

February 28, 2026Open Access

Protocol-Specific Luteinizing Hormone Thresholds for IVF Pregnancy Outcomes: The Moderating Role of Age in a Retrospective Study of 217 Cycles

Key Points

To determine the effect of trigger-day luteinizing hormone levels on IVF pregnancy outcomes in different protocols and the role of age.
Retrospective analysis of 217 IVF/ICSI cycles from January 2023 to April 2024.
Comparison of trigger-day luteinizing hormone levels and pregnancy outcomes using ROC curves and multivariate logistic regression.
Mediation models to assess the influence of age on outcomes.
In the antagonist protocol, LH levels > 1.45 IU/L correlated with lower oocyte yield and higher clinical pregnancy failure risk.
In the long protocol, LH levels > 1.0 IU/L were associated with higher clinical pregnancy rates with 68% mediated by increased oocyte yield.
Age ≤ 35 enhanced the outcomes significantly, indicating that age interacts with LH thresholds.

Abstract

Objective: To explore the impact of trigger-day luteinizing hormone (LH) levels on pregnancy outcomes in antagonist and long protocols during in vitro fertilization (IVF) and determine protocol-specific LH thresholds. Methods: This retrospective analysis covered 217 IVF/ICSI cycles from January 2023 to April 2024. The relationships between trigger-day LH levels and pregnancy outcomes in the two protocols were compared using ROC curves, multivariate logistic regression, and mediation models. Results: In the antagonist protocol, LH > 1.45 IU/L was linked to lower oocyte yield, reduced high-quality embryo rates, and a higher risk of clinical pregnancy failure (RR = 2.34, p = 0.006). In the long protocol, LH > 1.0 IU/L was associated with higher clinical pregnancy rates (OR = 2.61, p = 0.026), with 68% of the effect mediated by increased oocyte yield. Age ≤ 35 significantly enhanced these effects (three-way interaction OR = 6.55, p = 0.003). Conclusion: The antagonist and long protocols should adopt LH thresholds of 1.45 IU/L and 1.0 IU/L, respectively. Age is a key moderator, providing evidence for individualized IVF trigger strategies. Keywords: luteinizing hormone, antagonist protocol, long protocol, in vitro fertilization, clinical pregnancy, age interaction

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Cite This Study

Zhao et al. (Sun,) studied this question.

synapsesocial.com/papers/69a286da0a974eb0d3c022cd https://doi.org/https://doi.org/10.2147/ijwh.s581964

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