Han Xu, Liu Chang, Wang Jie, Zheng Ye, Wang Huidan, Sun Mei, Li Xiufang
State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University, 157 Jingliu Road, Jinan, 250012, Shandong Province, China.
National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.
J Ovarian Res. 2025 Jul 19;18(1):158. doi: 10.1186/s13048-025-01743-x.
In hormone replacement therapy-frozen-thawed embryo transfer (HRT-FET) cycles, endogenous LH levels may still rise, and the relationship between this and pregnancy outcomes is unclear. The purpose of this study was to investigate the correlation between the serum LH levels before progesterone administration in HRT-FET cycles and the live birth rate (LBR).
A total of 13 720 HRT-FET cycles were divided into four groups based on serum LH levels according to the quartiles. Meanwhile, subgroup analyses were performed based on the use of pituitary down-regulation to evaluate the independent effects of serum LH levels on pregnancy outcomes. We used multivariate logistic regression analysis to adjust for potential confounding factors.
In the overall, the 51-75th percentile group showed significant differences in LBR and miscarriage rate compared to the reference group (P = 0.010; P = 0.004), and the > 75th percentile group showed significant difference in biochemical pregnancy rate compared to the reference group (P = 0.022). In the non-pituitary down-regulation group, the 51-75th percentile group and the reference group exhibited significant differences in LBR and miscarriage rate (P = 0.004), and the 26-50th percentile group showed significant difference in miscarriage rate compared to the reference group (P = 0.026). In the pituitary down-regulation group, the > 75th percentile group showed significant difference in biochemical pregnancy rate compared to the reference group (P = 0.045).
In HRT-FET cycles, low serum LH levels prior to progesterone administration may be associated with poor pregnancy outcomes. For patients presenting with low LH levels, we may recommend deferring the FET cycle to reduce poor pregnancy outcomes.
在激素替代疗法-冻融胚胎移植（HRT-FET）周期中，内源性促黄体生成素（LH）水平仍可能升高，其与妊娠结局之间的关系尚不清楚。本研究的目的是探讨HRT-FET周期中孕激素给药前血清LH水平与活产率（LBR）之间的相关性。
根据四分位数将总共13720个HRT-FET周期按血清LH水平分为四组。同时，根据垂体降调节的使用情况进行亚组分析，以评估血清LH水平对妊娠结局的独立影响。我们使用多因素逻辑回归分析来调整潜在的混杂因素。
总体而言，第51-75百分位数组与参照组相比，在活产率和流产率方面存在显著差异（P = 0.010；P = 0.004），第>75百分位数组与参照组相比，在生化妊娠率方面存在显著差异（P = 0.022）。在非垂体降调节组中，第51-75百分位数组与参照组在活产率和流产率方面存在显著差异（P = 0.004），第26-50百分位数组与参照组相比，流产率存在显著差异（P = 0.026）。在垂体降调节组中，第>75百分位数组与参照组相比，生化妊娠率存在显著差异（P = 0.045）。
在HRT-FET周期中，孕激素给药前血清LH水平较低可能与不良妊娠结局相关。对于LH水平较低的患者，我们可能建议推迟FET周期以减少不良妊娠结局。
