The effectiveness and safety of recombinant human LH to support folliculardevelopment induced by recombinant human FSH in WHO group I anovulation: evidence from a multicentrestudy in Spain.
Journal Title: Human Reproduction (Oxford) - Year 2002, Vol 16, Issue 12
Abstract
BACKGROUND: Until recently, human menopausal gonadotrophin (HMG), a urinaryextract containing a fixed combination of LH and FSH, was the only source of exogenous LH for women withhypogonadotrophic hypogonadism undergoing ovulation induction with gonadotrophins. Recombinant humanLH (rLH) is now available for clinical use, providing a new treatment option but clinical data on itsuse are scanty. Therefore, the aim of the present study was to investigate the efficacy and safety ofrLH combined with recombinant FSH (rFSH) to induce follicular development and ovulation in World HealthOrganization (WHO) group I anovulatory women. METHODS: We included in this multicentre study 38 hypogonadotrophicanovulatory (WHO group I) women. Patients received 150 IU/day rFSH and 75 IU/day rLH (with the possibilityof dose adjustment) as a single s.c. injection for up to three cycles with a total of 84 treatment cycles.RESULTS: Sufficient follicular growth was observed in 79 (94%) out of 84 initiated cycles. The 75 IUrLH dose was found to be effective in most treatment cycles (94%) and only five cycles in three patientsrequired daily dose increase. Overall, HCG was administered to trigger ovulation in 67 (80%) of the 84cycles while it was withheld in 12 cycles (14%) due to ovarian hyper-response and five cycles (6%) werecancelled for insufficient follicular growth. The pregnancy rate per started treatment cycle and percycle given HCG was 18 and 22.4% respectively. Pregnancy was achieved by 15 (39.5%) of the 38 patients.Mild to moderate ovarian hyperstimulation syndrome occurred in three patients. Local tolerance was good.CONCLUSIONS: This study confirms that combined rFSH and rLH treatment induces follicular growth, ovulationand pregnancy in a good proportion of hypogonadotrophic anovulatory patients and is well tolerated. Thedoses of 150 IU rFSH and 75 IU rLH daily seem the most appropriate but in a small minority of patientsdoses >75 IU rLH/day may be necessary.
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S Burgués
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