RELATIONSHIP BETWEEN SERUM LH LEVELS ON THE HCG TRIGGER DAY AND LIVE BIRTH RATES FOLLOWING FRESH EMBRYO TRANSFER WITH GNRH ANTAGONIST PROTOCOLS

Abstract

Objective

Determining if serum LH levels on the hCG trigger day are correlated with live birth rates (LBR) following fresh embryo transfer with GnRH antagonist protocols.

Materials and Methods

A retrospective study was conducted at a university-based infertility clinic between January 2015 and December 2021. Participants were women aged 20-40 undergoing in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) with fresh embryo transfer following a GnRH antagonist protocol. Women with normal basal FSH and TSH were included in the study. Exclusion criteria for the study were polycystic ovary syndrome (PCOS), poor responder status, recurrent abortions, and uterine abnormalities. Patients were categorized into two groups based on live birth (LB) and both groups were compared according to their age, antral follicle count (AFC), AMH, FSH, LH, progesterone, and estradiol levels, duration of stimulation, the dose of gonadotropins used, quality, and quantity of oocytes and embryos.

Results

Age, AFC, AMH, FSH, LH, and estradiol levels on D3, endometrial thickness on trigger day, total dose of gonadotropins used, duration of stimulation, starting day of antagonist administration, progesterone and estrogen levels on the hCG trigger day, follicles ≥14 mm and ≥17 mm on the trigger day, number of oocytes retrieved, number of MII oocytes, number of embryos and number of quality embryos were comparable in both groups. LH levels on the trigger day were the sole distinguishing characteristic between the two groups (Table 1).

Discussion and Conclusion

Our results revealed that elevated serum LH levels on the trigger day are linked to higher live births following fresh embryo transfer in GnRH antagonist cycles. It has been demonstrated in previous studies that LH plays a crucial role in various reproductive processes, including follicle development, ovulation, steroidogenesis, luteal function, and endometrial development (1,2). Our findings, which showed a significant discrepancy in LH levels on trigger day between the two groups suggest that elevated LH levels may contribute to higher implantation rates. Zhou et al. demonstrated in a large cohort that there is a positive association between serum LH levels on hCG trigger day and Iive birth rate after fresh embryo transfer in both normal ovarian responders and patients with PCOS (3). LH could serve as a predictive marker for determining whether to proceed with fresh embryo transfer in IVF cycles to optimize clinical outcomes.