Huang Chenyang, Shi Qingqing, Yan Yuan, Shen Xiaoyue, Shan Huizhi, Zhu Yingchun, Sun Haixiang, Xing Jun, Kong Na
Center for Reproductive Medicine and Obstetrics and Gynecology, Drum Tower Clinic Medical College of Nanjing Medical University, Nanjing, People's Republic of China.
Reproductive Medicine Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China.
Int J Womens Health. 2022 Dec 13;14:1691-1700. doi: 10.2147/IJWH.S388726. eCollection 2022.
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?
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.
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).
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.
促黄体生成素(LH)的适时适量分泌在卵泡发育和成熟过程中起着关键作用。然而,在体外受精/卵胞浆内单精子注射与胚胎移植(IVF/ICSI-ET)周期中补充LH的作用仍不明确。在IVF/ICSI-ET周期中,补充LH能否改善接受长效促性腺激素释放激素激动剂(GnRHa)垂体降调节的患者的临床结局?
这是一项对2017年至2020年在南京鼓楼医院生殖医学中心进行的2600个长效GnRHa降调节IVF/ICSI周期的回顾性队列研究。根据是否补充LH将总周期分为两组。此外,我们进行了一项二次分析,使用倾向评分匹配来减少混杂因素的影响。
在逻辑回归分析中,添加外源性LH与临床妊娠率无显著相关性(OR=0.910,95%CI:0.623-1.311,p=0.61)。经过倾向评分匹配后,我们还发现补充LH与临床妊娠率之间无显著关联(OR=0.792,95%CI:0.527-1.191,p=0.26)。
在接受长效GnRHa IVF/ICSI-ET周期的非选择性患者中,补充外源性LH对临床妊娠率无明显影响,这表明不一定总是需要添加外源性LH,这在一定程度上有助于我们避免药物滥用。