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- W2022012808 abstract "Objective: To compare oocyte/embryo quality and treatment outcome in patients undergoing IVF/ICSI using recombinant human luteinizing hormone (rhLH) or human menopausal gonadotropin (hMG) as a supplement to recombinant human follicle-stimulating hormone (rhFSH) during controlled ovarian hyperstimulation. Design: Forty-nine women undergoing their first IVF cycle were prospectively randomized into two age-matched patient groups. Materials and Methods: All patients underwent standard down-regulation with GnRH agonist. After pituitary desensitization, patients were randomized to receive a fixed dose of either rhFSH (225 IU/d) plus hMG (75 IU/d) (group A, n = 28) or rhFSH (225 IU/d) plus rhLH (75 IU/d) (group B, n = 21). ICSI was performed in all cycles due to male factor infertility. Oocyte (Van Blerkom’s classification), zygote (Tesarik & Greco’s classification) and embryo quality (Veeck’s classification) along with the embryo fragmentation score (1 = ≤10%; 2 = 11–30%; 3 = >30%) were determined by the same embryologist. Results: Patient demographics (age, infertility duration, body mass index, gonadotropin ampoules, duration of stimulation) were similar in both groups. Mean E2 and P levels and endometrial thickness on the day of hCG administration were similar in both groups. The mean number of M2 oocytes recovered showed no difference between groups. However, the mean number of normal/abnormal M2 oocytes was 4.5±3.10/2.8±3.13 for group A and 2.4±1.47/4.0±3.70 for group B, a significant difference between groups (p = 0.006;p = 0.01; respectively). The incidence of major cytoplasmic abnormalities (dark/granular, clustered, SER) was similar in both groups. Nonetheless, the incidence of minor cytoplasmic abnormalities (vesiculated, necrotic, polarized, vacuolated) was significantly higher (p = 0.000) in group B (28.1%) than in group A (9.4%). The fertilization rate was similar in both groups (79.0%,86.0%; groups A and B respectively), yet the number of zygotes judged normal (pattern 0) was significantly higher (p = 0.02) in group A (2.4±2.40) when compared to group B (1.2±1.76). The embryo development rate (number of blastomeres/embryo), morphology and fragmentation scores were similar in the groups for both the day two and day three evaluations. The mean number of embryos, embryo quality and fragmentation scores before day three transfer were similar in both groups. Overall clinical pregnancy/implantation rates were 46.4% (13/28)/25.3% (22/87) in group A and 38.1% (8/21)/17.1% (13/76) in group B. The trend toward better pregnancy outcomes among patients in group A did not reach statistical significance. The miscarriage rate was similar in both groups (7.1%, 4.8%; groups A and B respectively). Conclusion: Our study suggests that the addition of recombinant luteinizing hormone instead of human menopausal gonadotropin to recombinant FSH throughout ovulation induction in down-regulated women undergoing IVF not only does not improve ovarian response, it has a negative impact on oocyte/zygote quality. The result is a trend toward poorer treatment outcome." @default.
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- W2022012808 date "2003-09-01" @default.
- W2022012808 modified "2023-10-14" @default.
- W2022012808 title "The effect of recombinant human luteinizing hormone on oocyte/embryo quality and treatment outcome in down-regulated women undergoing in vitro fertilization" @default.
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- W2022012808 doi "https://doi.org/10.1016/s0015-0282(03)02005-3" @default.
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