Evaluation of LH Level at Different Time Points During the Follicular phase in ICSI Cycle and Correlation with Pregnancy
DOI:
https://doi.org/10.28969/IJEIR.v12.i1.r4.22Keywords:
Keywords: Flexible GnRH antagonist protocol, criteria of antagonist initiation, Luteinizing hormone (LH), pregnancy Outcome.Abstract
Luteinizing hormone (LH) plays vital role for optimal follicular growth, maturation
and is responsible for inducing ovulation, various protocols in ICSI cycles used to
prevent the premature surge of luteinizing hormone. Currently, flexible GnRH
antagonist protocols appears to be mostly used protocols. individualization of
controlled ovarian hyper stimulation (COS) needs better timing of antagonist
administration, assessing variation in LH levels during COS helps in determining
appropriate initiation of inhibition .This prospective comparative observational
analysis was made on one hundred twenty females with infertility who were
undergoing ICSI flexible antagonist protocol at the “High Institute for Infertility
Diagnosis and Assisted Reproductive Technologies/Al-Nahrain University” from
October 2020 to April 2022, primary infertility was the with higher percentage
(78.3%) than the secondary type. However; the main cause of infertility among the
participant was male type (36.7%) fallowed by the combined one (20.8%). A highly
significant difference was present in LH levels at all time points, with level decreasing
from 4.99 ± 1.90 at baseline to 4.82± 2.15 at antagonist starting day to 1.63± 0.87 at
trigger day and p value was > 0.001, no statistical difference in LH levels regarding
the three time points between patients who get pregnant and non-pregnant women
with pregnant patients having higher baseline lower antagonist starting day, and
higher trigger LH levels 5.16 ± 1.87, 4.30 ± 1.72, 4.30 ± 1.72 respectively. Difference
in LH level between cycle day 2 and the day of antagonist starting according to
starting day of antagonist reveals that the basal LH values declined significantly (p=
<0.001) until cycle day 7 of stimulation after which the basal LH start to increase and
also with a high significant difference (negative values mean that the level decrease
in comparison to the base line level).The comparable LH level in the current study
reveals that earlier initiation of antagonist may serve no purpose and it is advisable to
include the measurement of LH level to the criteria of antagonist initiation for better
individualization and better outcome and to avoid un necessary earlier start of
antagonist.
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