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Year : 2021  |  Volume : 8  |  Issue : 2  |  Page : 166-172

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

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
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Source of Support: None, Conflict of Interest: None

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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