Clinical impact of LH rises prior to and during ganirelix treatment started on day 5 or on day 6 of ovarian stimulation

Reproductive Biology and Endocrinology

Bernadette Mannaerts⁴  Keith Gordon¹  Jolanda Elbers⁴  Han Witjes⁴  Frank J Broekmans³  Torbjörn Hillensjö²  John L Frattarelli⁵ 

[1] Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA;Fertility Center Scandinavia, Carlanderska Hospital, Göteborg, Sweden;Department of Reproductive Medicine, University Medical Center Utrecht, Utrecht, Netherlands;MSD Oss B.V., Oss, Netherlands;Advanced Reproductive Medicine & Gynecology of Hawaii, Inc., 1401 South Beretania St, Honolulu, Hawaii 96814, USA

关键词: Ongoing pregnancy rate;    Ovarian response;    Serum LH;    GnRH antagonist;    Ovarian stimulation;   

Others  :  809961
DOI  :  10.1186/1477-7827-11-90

 received in 2013-06-10, accepted in 2013-09-01,  发布年份 2013

【 摘 要 】

Background

We sought to evaluate the incidence and clinical impact of luteinizing hormone (LH) rises prior to and during gonadotropin-releasing hormone (GnRH) antagonist treatment started on day 5 or 6 of ovarian stimulation with recombinant follicle-stimulating hormone (rFSH).

Methods

Pooled data from three trials with the GnRH antagonist ganirelix started on day 5 (n = 961) and from five trials with ganirelix started on day 6 (n = 1135) of ovarian stimulation with rFSH were retrospectively analyzed.

Results

The incidence of LH rises (LH ≥ 10.0 IU/L) prior to ganirelix treatment was 2.3% and 6.6% on ganirelix start days 5 and 6, respectively (P < 0.01). During ganirelix treatment this incidence was 1.2% and 2.3%, respectively (P = 0.06). Women with LH rise on day 5 or 6 had a higher ovarian response with more oocytes recovered, mean ± SD, 12.9 ± 8.5 versus no LH rise, 10.2 ± 6.4 (P < 0.01). In women with and without LH rise prior to ganirelix treatment the ongoing pregnancy rates were similar (26.0% vs 29.9%; odds ratio [OR], 0.89; 95% confidence interval [CI], 0.55-1.44). Women with LH rise during ganirelix treatment had a lower ovarian response with 7.5 ± 6.7 oocytes recovered versus no LH rise, 10.2 ± 6.4 (P = 0.02) and a tendancy for a lower chance of ongoing pregnancy (16.7% vs 29.9%; OR, 0.52; 95% CI, 0.21-1.26).

Conclusions

The incidence of early and late LH rises was low but may be further reduced by initiating ganirelix on stimulation day 5 rather than on day 6. In contrast to women with an early LH rise, women with a late LH rise may have a reduced chance of ongoing pregnancy.

【 授权许可】

   
2013 Frattarelli et al.; licensee BioMed Central Ltd.

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