Effectiveness of recombinant luteinizing hormone/human menopausal gonadotropin/letrozole as additives to recombinant follicle-stimulating hormone in women with poor ovarian reserve undergoing controlled ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection

Rashmi Agrawal , Abha Majumdar , Shweta M Gupta , Deepanshu Gupta


To compare the addition of fixed dose additives namely recombinant luteinizing hormone (rLH), human menopausal gonadotropin (hMG), and letrozole to conventional doses of recombinant follicle-stimulating hormone (rFSH) on ovarian response and treatment outcome among women with poor ovarian reserve (POR) undergoing controlled ovarian stimulation for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).

 Materials and methods: In this prospective quasirandomized study, participants (N = 120) were randomized into three equal groups. rFSH with one additive (rLH, hMG, letrozole) was administered to patients from day 2/3 of cycle. Clinical, ongoing, and early pregnancy rates were primary outcome measures. Total number of oocytes retrieved, number of transferable embryos, cycle cancellation, and fertilization rates were secondary outcome measures. 

Results: Group A patients had higher clinical pregnancy rate (42.5%) than group B (20%) and group C (25%) with significant differences (P = 0.030) between groups A and B. Ongoing pregnancy rates were higher in group A (35%) compared to group B (12.5%) and group C (22.5%) with significant difference between groups A and B (P = 0.010). Number of patients with early pregnancy loss was numerically equivalent in all three groups. Group C showed significantly decreased levels of estradiol compared with other groups. No significant differences in secondary outcomes were observed among the groups. 

Conclusion: The current study demonstrates benefits of rLH in early stages of stimulation in patients with POR in terms of improvement in IVF/ICSI-associated outcomes. Further larger randomized studies are required to confirm this effect, given a modest sample size in this study.

More Publications

Advances in neuropathic pain management: A review of real-world studies

Swati S. Dash , Nikhil K. Khatri , Divyateja Saraswathi , Jignesh Bhate , Guruprasad Rao KS

Apr, 2024

Journal of Current Research in Scientific Medicine

Impact of Acne Vulgaris and Sarecycline on Social/Emotional Functioning and Daily Activities: PROSES Study

Emmy Graber , Hilary E. Baldwin , Richard G. Fried , Evan A. Rieder , Adelaide A. Hebert , James Del Rosso , Leon Kircik , Linda Stein Gold , Julie C. Harper , Andrew F. Alexis , Siva Narayanan , Volker Koscielny , Ismail Kasujee

Feb, 2024

Journal of Drugs in Dermatology (JDD)

Semaglutide and Obesity: Real-World Clinical Applications and Outcomes

Swati Sucharita Dash , Merlin Roshma Sherin , Debalina Das , Guruprasad KS Rao

Mar, 2024

International Journal of Medical Science Research and Practice