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Does the addition of recombinant LH in WHO group II anovulatory women over-responding to FSH treatment reduce the number of developing follicles? A dose-finding study.

AbstractBACKGROUND:
In anovulatory women undergoing ovulation induction, addition of recombinant human LH (rLH) to FSH treatment may promote the dominance of a leading follicle when administered in the late follicular phase. The objective of this study was to find the optimal dose of rLH that can maintain the growth of a dominant follicle, whilst causing atresia of secondary follicles.
METHODS:
Women with infertility due to anovulation and over-responding to FSH treatment were randomized to receive, in addition to 37.5 IU recombinant human FSH (rFSH), either placebo or different doses of rLH (6.8, 13.6, 30 or 60 microg) daily for a maximum of 7 days. The primary efficacy endpoint was the proportion of patients who had exactly one follicle > or = 16 mm on hCG day.
RESULTS:
Among 153 enrolled patients, the five treatment groups were similar in terms of baseline characteristics. The proportion of patients with exactly one follicle > or = 16 mm ranged from 13.3% in the placebo group to 32.1% in the 30 microg rLH group (P = 0.048). The pregnancy rate ranged from 10.3% in the 60 microg group to 28.6% in the 30 microg rLH group. Adverse events were similar between groups.
CONCLUSIONS:
In patients over-responding to FSH during ovulation induction, doses of up to 30 microg rLH/day appear to increase the proportion of patients developing a single dominant follicle (> or = 16 mm). Our data support the 'LH ceiling' concept whereby addition of rLH is able to control development of the follicular cohort.
AuthorsJ N Hugues, J Soussis, I Calderon, J Balasch, R A Anderson, A Romeu, Recombinant LH Study Group
JournalHuman reproduction (Oxford, England) (Hum Reprod) Vol. 20 Issue 3 Pg. 629-35 (Mar 2005) ISSN: 0268-1161 [Print] England
PMID15618252 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Recombinant Proteins
  • Luteinizing Hormone
  • Follicle Stimulating Hormone
Topics
  • Adult
  • Anovulation (classification, drug therapy)
  • Dose-Response Relationship, Drug
  • Female
  • Follicle Stimulating Hormone (therapeutic use)
  • Humans
  • Luteinizing Hormone (administration & dosage, adverse effects, therapeutic use)
  • Ovarian Follicle (diagnostic imaging, drug effects)
  • Ovulation Induction
  • Pregnancy
  • Pregnancy Rate
  • Recombinant Proteins (administration & dosage, adverse effects, therapeutic use)
  • Treatment Outcome
  • Ultrasonography
  • World Health Organization

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