Effect of Exogenous Luteinizing Hormone (LH) Supplementation on Clinical Pregnancy of Patients Receiving Long-Acting Gonadotropin-Releasing Hormone Agonist (GnRHa) Cycles: A Retrospective Cohort Study

Chenyang Huang; Qingqing Shi; Yuan Yan; Xiaoyue Shen; Huizhi Shan; Yingchun Zhu; Haixiang Sun; Jun Xing; Na Kong

doi:10.2147/IJWH.S388726

Effect of Exogenous Luteinizing Hormone (LH) Supplementation on Clinical Pregnancy of Patients Receiving Long-Acting Gonadotropin-Releasing Hormone Agonist (GnRHa) Cycles: A Retrospective Cohort Study

Int J Womens Health. 2022 Dec 13:14:1691-1700. doi: 10.2147/IJWH.S388726. eCollection 2022.

Authors

Chenyang Huang^{1

2

3}, Qingqing Shi^{1

2

3}, Yuan Yan^{1

2

3}, Xiaoyue Shen^{1

2

3}, Huizhi Shan^{1

2

3}, Yingchun Zhu^{1

2

3}, Haixiang Sun^{1

2

3}, Jun Xing^{1

2

3}, Na Kong^{1

2

3}

Affiliations

¹ Center for Reproductive Medicine and Obstetrics and Gynecology, Drum Tower Clinic Medical College of Nanjing Medical University, Nanjing, People's Republic of China.
² Reproductive Medicine Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China.
³ Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, People's Republic of China.

Abstract

Purpose: Timely and moderate luteinizing hormone (LH) secretion plays critical roles in follicle development and maturation. However, the role of LH supplementation in in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) cycles remains unclear. Can LH supplementation improve the clinical outcomes of patients who receive long-acting gonadotropin-releasing hormone agonist (GnRHa) pituitary downregulation in IVF/ICSI-ET cycles?

Patients and methods: This is a retrospective cohort study of 2600 long-acting GnRHa down-regulated IVF/ICSI cycles from 2017 to 2020 in our reproductive medicine centre of Nanjing Drum Tower Hospital. Total cycles were divided into two groups according to LH supplementation or not. In addition, we conducted a secondary analysis that used propensity-score matching to reduce the effects of confounding.

Results: Exogenous LH addition was not significantly correlated with the clinical pregnancy rate (OR=0.910, 95% CI: 0.623-1.311, p=0.61) in logistic regression analysis. After propensity-score matching, we also found no significant association between LH supplementation and the clinical pregnancy rate (OR=0.792, 95% CI: 0.527-1.191, p=0.26).

Conclusion: There is no obvious effect of exogenous LH supplementation on the clinical pregnancy rate in non-selective patients receiving long-acting GnRHa IVF/ICSI-ET cycles, which suggests that exogenous LH addition is not always needed, which can help us avoid drug overuse to a certain extent.

Keywords: LH supplementation; clinical pregnancy rate; logistic regression analysis; long-acting GnRHa; propensity-score matching.

Grants and funding

This work was supported by the National Natural Science Foundation of China (81801530) and Reproductions Research Program of Young and Middle-aged Physicians and China Health Promotion Foundation (BJHPA-2022-SHZHYXZHQNYJ-LCH-002). There is no conflict of interests.