Addition of neither recombinant nor urinary luteinizing hormone was associated with an improvement in the outcome of autologous in vitro fertilization/intracytoplasmatic sperm injection cycles under regular clinical settings: a multicenter observational analysis

Objective To determine whether the addition of either urinary or recombinant LH in patients undergoing routine clinical care improved the outcome in terms of the number of oocytes recovered for insemination or the delivery rate per initiated cycle. Design Cohort analysis. Patient(s) Couples undergoing IVF/ICSI in 158 institutions in 15 countries in Latin America. Setting In vitro fertilization clinics. Intervention(s) We compared the outcome of three different protocols of COH, including rFSH only, rFSH plus rLH, and rFSH plus hMG. Main Outcome Measure(s) The number of mature oocytes recovered and inseminated; proportion of ETs at the blastocyst stage; clinical pregnancy, miscarriage, and delivery rates; proportion of cycles with embryo cryopreservation; and mean number of embryos cryopreserved. Result(s) After correcting for the age of the female partner, body mass index, number of embryos transferred, and stage of embryo development at transfer, we found that LH addition was not associated with an increase in the mean number of metaphase II oocytes inseminated or with an increase in the delivery rate or changes in the miscarriage rate. Conclusion(s) Our study strongly suggests that in routine clinical practice, the type of controlled ovarian stimulation—FSH alone or in combination with LH—has little impact on the outcome of assisted reproductive technology; therefore a more friendly and accessible alternative should be favored.