Recombinant human luteinizing hormone supplementation may improve embryo quality in in vitro fertilization/intracytoplasmic sperm injection cycles with gonadotropin-releasing hormone antagonist protocol

Objective: To evaluate the effects of recombinant LH (rLH) supplementation on embryo quality in IVF/ICSI cycles with GnRH antagonist. Study design: Prospective, randomized controlled study. Thirty women were enrolled, 15 in the study (FSH + rLH) group and 15 in the control (rFSH only) group. On the day GnRH antagonist was started, the study group patients received 75 IU of rLH in addition to rFSH. The main outcome measures were embryo quality, number of oocytes retrieved, and fertilization rate. Results: The rLH group had significantly more top-quality embryos (36/43, 84%) compared to the control group (40/68, 59%; p = 0.006). Fertilization rates and number of oocytes retrieved were similar between groups. Progesterone and estradiol (E2) concentrations in follicular fluid were higher in the study group compared to controls (16.5 ± 2.5 µg/ml vs. 11.4 ± 3.6 µg/ml progesterone, P = 0.07; and 687 ± 112 pg/ml vs. 471 ± 65 pg/ml E2, p = 0.08). Conclusion: Adding rLH to ovarian stimulation with GnRH antagonist can yield higher quality embryos.