A Premature Rise of Luteinizing Hormone Is Associated With a Reduced Cumulative Live Birth Rate in Patients ≥37 Years Old Undergoing GnRH Antagonist In Vitro Fertilization Cycles

Front Endocrinol (Lausanne). 2021 Dec 2:12:722655. doi: 10.3389/fendo.2021.722655. eCollection 2021.

Abstract

This is a retrospective cohort study included 1021 patients underwent a flexible GnRH antagonist IVF protocol from January 2017 to December 2017 to explore the effect of a premature rise in luteinizing hormone (LH) level on the cumulative live birth rate. All patients included received the first ovarian stimulation and finished a follow-up for 3 years. A premature rise in LH was defined as an LH level >10 IU/L or >50% rise from baseline during ovarian stimulation. The cumulative live birth rate was calculated as the number of women who achieved a live birth divided by the total number of women who had either delivered a baby or had used up all their embryos received from the first stimulated cycle. In the advanced patients (≥37 years), the cumulative live birth rate was reduced in patients with a premature rise of LH (β: 0.20; 95% CI: 0.05-0.88; p=0.03), compared to patients (≥37 years) without the premature LH rise. The incidence of premature LH rise is associated with decreased rates of cumulative live birth rate in patients of advanced age (≥37 years) and aggravated the reduced potential of embryos produced by the advanced age, not the number of embryos.

Keywords: GnRH antagonist; IVF; advanced aged patients; cumulative live-birth rate; premature rise of LH.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • China / epidemiology
  • Cohort Studies
  • Female
  • Fertilization in Vitro / methods*
  • Fertilization in Vitro / statistics & numerical data
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors
  • Hormone Antagonists / therapeutic use*
  • Humans
  • Live Birth / epidemiology*
  • Luteinizing Hormone / blood*
  • Maternal Age*
  • Ovulation Induction / methods
  • Ovulation Induction / statistics & numerical data
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnancy Rate
  • Retrospective Studies
  • Time Factors
  • Up-Regulation

Substances

  • Hormone Antagonists
  • Gonadotropin-Releasing Hormone
  • Luteinizing Hormone