The Effect On IVF Pregnancy Outcome Of R-LH Supplement In Different Time In Assisted Reproductive Technology

Purpose: To investigate the effect of using luteinizing hormone(LH) added during late follicular phase in controlled ovarian hyperstimulation( COH) cycles of in vitro fertilization/ intracytoplasmic sperm injection- embryo transfer(IVF/ICSI-ET). To explore the effectiveness of adding r-LH as luteal support during embryo transfer days.Method: Part1: Retrospective analysis of 354 cycles of IVF/ICSI-ET in our reproductive medical centre from January 2013 to July 2015 was performed, pituitary down- regulation standard long protocol was adopted, all the patients were divided into two groups: additive r-LH group and additive free group. Each group was then divided into two groups.To compare the following indicators:(1)women's basic indicators: age?BMI?infertility time?the basis serum hormone(bFSH,bLH,bE2) levels of the early follicular phase and the antral follicle count(AFC);(2)Stimulate ovulation situation: the days of Gn?the levels of LH?E2?P and retrieved oocyte number on the day of HCG injection, the levles of E2?P and endometrial thickness on the ET day;(3)Pregnancy outcome: fertilization rate, cleavage rate, embryo rate, growing rate, clinical pregnancy rate and abortion rate.Part2: Retrospective analysis of 799 cycles of IVF/ICSI-ET in our reproductive medical centre from January 2013 to July 2015 was performed, all the patients were divided into two groups: additive r-LH group and additive free group. Each group was then divided into two groups:<35 years and > 35 years. To compare the following indicators: the levles of E2?P and endometrial thickness on the ET day; Pregnancy outcome: fertilization rate, cleavage rate, embryo rate, growing rate, clinical pregnancy rate and abortion rate.Result: Part1: In general:the LH levle on the HCG day: additive r-LH group is significantly higher than the additive free group; the E2 levle on the ET day, additive r-LH group is significantly lower than the additive free group;fertility rate of the ICSI: additive r-LH group is significantly higher than the additive free group; cleavage rate: additive r-LH group is significantly higher than the additive free group;implantation rate and pregnancy rate: additive r-LH group is significantly higher than the additive free group; the indicators of age?BMI?infertility time?the levles of bFSH?bLH?bE2 ?the days of AFC and Gn?the levles of LH and E2 on the HCG day?the P level and the endometrial thickness and fertilization rate, cleavage rate, embryo rate on the ET day, all the differences had no statistical significance.Older than 35 years group: fertility rate and cleavage rate: additive r-LH group are significantly higher than the additive free group; implantation rate and pregnancy rate: additive r-LH group and additive free group had no statistic difference; the other two indicators had no statistic difference between the two groups.Younger than 35 years group:the LH level on the HCG day: additive r-LH group are significantly higher than the additive free group; endometrial thickness on the ET day: additive r-LH group are significantly higher than the additive free group; cleavage rate: additive r-LH group are significantly higher than the additive free group; implantation rate: additive r-LH group are significantly higher than the additive free group. the other two indicators had no statistic difference between the two groups.2. In general: E2?P level?endometrial thickness?fertilization rate?cleavage rate?embryo rate? growing rate? clinical pregnancy rate and abortion rate had no statistic difference between the two groups.Older than 35 years group: implantation rate: additive r-LH group are significantly higher than the additive free group; E2?P level?endometrial thickness?fertilization rate?cleavage rate?embryo rate? growing rate? clinical pregnancy rate and abortion rate had no statistic difference between the two groups.Younger than 35 years group: E2 ?P level?endometrial thickness?fertilization rate?cleavage rate?embryo rate? growing rate? clinical pregnancy rate and abortion rate had no statistic difference between the two groups.Conclusion: 1.In the long plan,when the LH<1.2 IU·mL-1,adding r-LH can improve the fertilization rate, cleavage rate and rate of planting; adding r-LH can improve the fertilization rate, cleavage rate among the aged patient; adding r-LH can improve the cleavage rate and the implantation among the young patients.2. Adding r-LH properly on the embryo transfer day can improve the implantation rate among the aged patients, it can be a supplement of the corpus luteum.