Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, MD 20892, USA.
Reprod Biomed Online. 2012 Mar;24(3):261-71. doi: 10.1016/j.rbmo.2011.12.005. Epub 2011 Dec 20.
A review of the scientific literature on the use of exogenous LH in assisted reproductive technology was performed by searching the MEDLINE, PubMed and Cochrane online databases. Scientific evidence was reviewed comparing recombinant FSH-only protocols to protocols supplemented with exogenous LH activity: human menopausal gonadotrophin (HMG), recombinant LH and mid-follicular human chorionic gonadotrophin (HCG). Studies were further compared based on pituitary suppression with gonadotrophin- releasing hormone (GnRH) antagonist and agonist protocols. Primary focus was given to randomized controlled trials and meta-analyses. Data from hypogonadotrophic hypogonadal patients demonstrated the importance of LH activity for success of assisted reproduction treatment. However, the majority of normogonadotrophic patients had adequate endogenous LH to successfully drive ovarian steroidogenesis and oocyte maturation. Exogenous LH supplementation was consistently associated with higher peak oestradiol concentrations. The use of HMG in long GnRH agonist cycles was associated with a 3–4% increase in live birth rate. There was insufficient evidence to make definitive conclusions on the need for exogenous LH activity in GnRH antagonist cycles or the benefit of recombinant LH and HCG protocols. Poor responders and patients 35 years of age and older may benefit from exogenous LH.
对辅助生殖技术中外源性 LH 应用的科学文献进行了综述，检索了 MEDLINE、PubMed 和 Cochrane 在线数据库。对仅使用重组 FSH 的方案与补充外源性 LH 活性的方案（人绝经期促性腺激素 (HMG)、重组 LH 和中卵泡期人绒毛膜促性腺激素 (HCG)）进行了比较，比较了基于 GnRH 拮抗剂和激动剂方案的垂体抑制的研究。主要关注随机对照试验和荟萃分析。来自低促性腺激素性性腺功能减退症患者的数据表明 LH 活性对辅助生殖治疗成功的重要性。然而，大多数正常促性腺激素的患者有足够的内源性 LH 成功地驱动卵巢甾体生成和卵母细胞成熟。外源性 LH 补充剂始终与更高的峰值雌二醇浓度相关。在长 GnRH 激动剂周期中使用 HMG 可使活产率提高 3-4%。在 GnRH 拮抗剂周期中是否需要外源性 LH 活性或重组 LH 和 HCG 方案的益处，尚无足够的证据得出明确的结论。低反应者和年龄 35 岁及以上的患者可能受益于外源性 LH。
