Recombinant gonadotrophins associated with GnRH antagonist (cetrorelix) in ovarian stimulation for ICSI: Comparison of r-FSH alone and in combination with r-LH

Paolo E. Levi-Setti, Mario Cavagna, Carlo Bulletti

Research output: Contribution to journalArticle

Abstract

Objective: The objective was to verify the outcome of intracytoplasmic sperm injection (ICSI) with ovulation induction performed with GnRH antagonists, comparing the use of recombinant follicle-stimulating hormone (r-FSH) alone and in combination with recombinant luteinizing hormone (r-LH) in a prospective and randomized trial. Study design: Forty male-factor infertile normo-ovulatory patients undergoing ovarian stimulation for ICSI took part in the study. After initiating ovarian stimulation with only r-FSH, all patients were treated with GnRH antagonist (cetrorelix). When beginning cetrorelix administration, the patients were randomized into two groups: in group I, 20 patients continued to receive r-FSH alone and in group II, 20 patients received combined r-FSH and r-LH. The number of metaphase II oocytes, estradiol concentration at the time of hCG administration, fertilization rate, grade 1 embryo rate, pregnancy rate per cycle, and implantation rate were measured. Results are expressed as mean ± S.D. Results: In group I, the women's age was 32.3 ± 2.30 years, and FSH concentration was 7.8 ± 1.7 IU/ml. In group II, the women's age was 32.2 ± 2.46 years and FSH concentration was 7.5 ± 1.7 IU/ml. The number of oocytes retrieved was 9.6 ± 2.9 and the number of metaphase II oocytes was 6.7 ± 2.2 in group I. In group II the number of retrieved oocytes were 9.9 ± 2.6 and the number of metaphase II oocytes 6.9 ± 2.1 (p > 0.05). Estradiol concentration at the time of hCG was 4.6 ± 1.8 nm/l in group I and 6.7 ± 2.0 nm/l in group II (p <0.01). Fertilization rate was 73.0% in group I versus 78.2% in group II. In group I, we obtained 53.9% of grade 1 embryos versus 54.4% in group II (p > 0.05). Pregnancy and implantation rates in group I were 30.0 and 16.7%, respectively and in group II 35.0 and 20.4%, respectively (p > 0.05). Conclusions: The use of recombinant LH in addition to recombinant FSH may prevent a decrease in estradiol after GnRH antagonist administration, but does not influence positively the outcome of oocyte number, maturation, embryo quality, fertilization rate, pregnancy rate per cycle, and implantation rate.

Original languageEnglish
Pages (from-to)212-216
Number of pages5
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Volume126
Issue number2
DOIs
Publication statusPublished - Jun 1 2006

Keywords

  • Cetrorelix
  • GnRH antagonist
  • Ovarian stimulation
  • Recombinant FSH
  • Recombinant LH

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

Fingerprint Dive into the research topics of 'Recombinant gonadotrophins associated with GnRH antagonist (cetrorelix) in ovarian stimulation for ICSI: Comparison of r-FSH alone and in combination with r-LH'. Together they form a unique fingerprint.

  • Cite this