| ORIGINAL ARTICLE |
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| Year : 2021 | Volume
: 8
| Issue : 2 | Page : 166-172 |
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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 Agrawal1, Abha Majumdar1, Shweta M Gupta1, Deepanshu Gupta2
1 Centre of IVF and Human Reproduction, Sir Gangaram Hospital, New Delhi, India
2 CK Birla Hospital, Gurugram, India
Correspondence Address:
Dr. Rashmi Agrawal
Centre of IVF and Human Reproduction, Sir Gangaram Hospital, Flat no 001, Tower A1, Unitech the Residences (Near Yaduvashi School), Sector 33, Gurugram 122001, New Delhi
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/fsr.fsr_35_21
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Background: 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.
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