Lisi Franco, Rinaldi Leonardo, Fishel Simon, Caserta Donatella, Lisi Rosella, Campbell Alison
BIOGENESI, Casa di Cura Villa Europa all'EUR, Rome, Italy.
Fertil Steril. 2005 Feb;83(2):309-15. doi: 10.1016/j.fertnstert.2004.07.969.
To evaluate the efficacy of two doses of recombinant (r)LH, 75 IU (recommended) or 37.5 IU, for follicular stimulation and outcomes in a randomized cohort of IVF patients.
Randomized, prospective analysis.
Private hospital incorporating an established IVF center.
PATIENT(S): Women undergoing IVF who had a body mass index >18 or <35 and no abnormal karyotype, anovulation, oligomenorrhea, or any known endocrinopathy/illness.
INTERVENTION(S): Pituitary desensitization was achieved with triptorelin (0.1 mg SC), and gonadotropin stimulation was performed with either rFSH alone (group A) or in combination with rLH in one of two doses: 37.5 IU (group B) or 75 IU (group C), daily.
MAIN OUTCOME MEASURE(S): A range of endocrinologic, embryologic, clinical, and outcome parameters were evaluated.
RESULT(S): With rLH supplementation there was a significant increase in the incidence of implantation (9% for rFSH only [group A] vs. 11% and 16% with 37.5 IU rLH and 75.0 IU rLH [groups B and C], respectively) and clinical pregnancy (19% vs. 23% and 31%) (P<.01 and P<.04, respectively), whereas there was no difference in the multiple pregnancy rates. There was a significant (P<.001) increase in the total units of rFSH used in proportion to the amount of rLH supplementation (2,645 U vs. 3,475 U and 3,681 U) and in the level of peripheral E(2) on the day of hCG administration (1,049 pg/mL vs. 1,640 pg/mL and 1,226 pg/mL) (P<.001). There was no significant between difference in mean age, numbers of oocytes recovered, basal and downregulation hormone levels, or the incidence of fertilization in the absence or presence of rLH supplementation, but a higher incidence of grade 1 to 2 embryos was observed when rLH was supplemented.
CONCLUSION(S): After pituitary desensitization, there was an increase in the incidence of implantation, clinical pregnancy, and delivery rates in patients stimulated with rFSH supplemented with rLH.
评估两种剂量的重组促黄体生成素（rLH），即75 IU（推荐剂量）或37.5 IU，对体外受精（IVF）患者进行卵泡刺激的疗效及结局。
随机前瞻性分析。
设有成熟IVF中心的私立医院。
接受IVF治疗的女性，体重指数>18或<35，无染色体核型异常、无排卵、月经过少或任何已知的内分泌疾病/病症。
用曲普瑞林（0.1 mg皮下注射）使垂体脱敏，并用单独的重组促卵泡激素（rFSH）（A组）或与两种剂量之一的rLH联合使用进行促性腺激素刺激：37.5 IU（B组）或75 IU（C组），每日一次。
评估一系列内分泌、胚胎学、临床和结局参数。
补充rLH后，着床率显著提高（仅使用rFSH时为9%[A组]，使用37.5 IU rLH和75.0 IU rLH时分别为11%和16%[B组和C组]），临床妊娠率也显著提高（19%对23%和31%）（P<0.01和P<0.04），而多胎妊娠率无差异。与rLH补充量成比例，使用的rFSH总单位数显著增加（P<0.001）（2645 U对3475 U和3681 U），且在注射人绒毛膜促性腺激素（hCG）当天外周雌二醇（E₂）水平显著增加（1049 pg/mL对1640 pg/mL和,226 pg/mL）（P<0.001）。在补充或不补充rLH的情况下，平均年龄、回收的卵母细胞数量、基础和下调激素水平或受精率之间无显著差异，但补充rLH时观察到1至2级胚胎的发生率更高。
垂体脱敏后，补充rLH的rFSH刺激的患者着床率、临床妊娠率和分娩率增加。
