Effects of low LH serum levels on oocyte retrieval, fertilization rate and embryo quality during controlled ovarian stimulation: results from a prospective cohort analysis

Abstract

Abstract Luteinizing hormone plays a key role in normal follicular development and oocyte maturation in controlled ovarian stimulation. Luteinizing hormone stimulates the proliferation and differentiation of theca cells for the secretion of androgens, synergistically increasing estrogen production. This study aimed to investigate the effects of low luteinizing hormone concentrations on oocyte retrieval, fertilization and embryo development in patients undergoing in vitro fertilization/intracytoplasmic sperm injection. We prospectively analyzed patients undergoing in vitro fertilization/intracytoplasmic sperm injection, subdividing them into three groups according to their age. Serum luteinizing hormone levels were evaluated on day 3, during stimulation (day 10) and before ovulation induction (day 12). Our data analysis suggests that serum luteinizing hormone levels progressively decrease during controlled ovarian stimulation, and this effect is more evident in the early phase of this procedure. From this perspective, circulating luteinizing hormone levels may significantly decrease during the late follicular phase due to the negative feedback of ovarian hormones from multiple follicular developments or after the suppressive effects of gonadotropin releasing hormone antagonist. Based on these findings, exogenous luteinizing hormone may be considered a strategy in women with a decrease in luteinizing hormone levels during ovarian stimulation in order to improve oocyte quality and reproductive outcome.