LH level does not indicate poor response to GnRh-a single trigger: A retrospective analysis

Abstract

AbstractObjective:To compare the embryo condition and clinical outcomes between patients with low and normal serum luteinizing hormone (LH) levels on the day after a single trigger of gonadotropin-releasing hormone agonist (GnRH-a). In patients with low LH levels we further analyzed the efficacy of human chorionic gonadotropin (HCG) to trigger ovulation.Methods:We retrospectively analyzed 957 infertile patients (tubal factor, ovulation disorders, male sperm factor, or unexplained infertility) who were treated with in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI)-assisted pregnancy at the Chengdu Xinan Gynecology Hospital from July 2017 to December 2020. Patients with sufficient GnRH-a single trigger and normal serum LH levels on the next day were used as the control group (n=906), and patients with low LH levels were set as the experimental group (n=51), of whom 10 received HCG retriggering. We analyzed the effects of low and normal LH levels, and the efficacy HCG retriggering in patients with low LH level on the embryo status and embryonic transplantation after cryopreservation outcome of patients.Results:There were no significant differences in egg yield, 2PN fertilization rate, excellent embryo rate, or live birth rate of frozen-thawed embryos between patients with low and normal LH levels after GnRH-a trigger. There was also no difference in patients with low LH levels who received HCG retriggering or not.Conclusion:The outcomes of patients with low LH levels on the day after GnRH-a administration were similar to those of patients with normal LH levels. The embryo status and live birth rate of frozen-thawed embryos in patients with low LH levels in the HCG retriggering and non-HCG retriggering groups are similar. When blood LH< 10 miu/ml was measured on the day after GnRH-a trigger, no special treatment was required, and there was no significant effect on embryonic and clinical outcomes. No blood LH test is required on the day following the trigger, which does not affect the outcome of in vitro fertilization.