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| Effects of the serum luteinizing hormone level of women on the day of human chorionic gonadotropin injection during the controlled ovarian stimulation cycle of in vitro fertilization-embryo transfer on their treatment cycle and pregnancy outcomes |
| 1. Jinjiang Maternal and Child Health Care Hospital of Chengdu, Chengdu, Sichuan Province, 610016；2. The First People's Hospital of Chengdu, Sichuan Province |
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Abstract To investigate the effects of different serum levels of luteinizing hormone (LH) of women on the day of human chorionic gonadotropin (HCG) injection during the controlled ovarian stimulation (COS) cycle of in vitro fertilization-embryo transfer (IVF-ET) on their gonadotropin Hormone (Gn) dosage frequency, the number of oocytes retrieved, efficacy, and pregnancy outcomes. Methods: A retrospective study was conducted on 166 women who underwent IVF-ET long-action and long-term assisted reproduction from June 2020 to December 2021. The women were divided into group A (49 women with LH ＜1IU/L), group B (87 women with 1 IU/L≤ LH ＜2 IU/L), and group C (40 women with LH ≥2IU/L) according to the LH level on the day of HCG injection. The dosage and days of Gn used, the number of oocytes retrieved, the endometrial thickness and estradiol (E2) level on the day of HCG injection, the rates of fertilization, cleavage, and quality embryo, and the pregnancy outcomes, such as symptomatic pregnancy rate and early miscarriage rate of the women in the three groups were observed. The correlation between the serum LH level of the women on the day of hCG injection and their dosage and days of Gn used was analyzed. The value of serum LH level of the women on the day of hCG injection for predicting their adverse pregnancy outcomes was also analyzed. Results: The dosage of Gn (2206.4±831.3 IU) and the days of Gn used (11.1±1.4 d) of the women in group C were significantly lower than those (2395.6±899.6 IU and 12.0±1.7 d) of the women in group A and those (2356.5±867.2 IU and 11.8±1.5 d) of the women in group B. The level of E2 of the women in group C on the day of hCG injection was significantly higher than that of the women in group A and group B. The endometrial thickness of the women in group C on the day of hCG injection was significantly lower than that of the women in group A and group B (all P＜0.05). There were no significant differences in the number of eggs obtained, the fertilization rate, the cleavage rate， and the optimal embryo rate of the women among the three groups (all P＞0.05). The pregnancy rate (57.5%) of the women in group C was significantly higher than that (34.7%) of the women in group A and that (37.9%) of the women in group B, the early abortion rate (5.0%) of the women in group C was significantly lower than that (18.4%) of the women in group A and that (11.5%) of the women in group B (P＜0.05), and which of the women had no significant differences between group A and group B (P＞0.05). The serum LH level of the women on the day of hCG injection was negatively correlated with the dosage and the days of Gn used (all P＜0.05). The area under the curve, the cut-off value, the specificity, and the sensitivity of the serum LH level of the women for predicting their adverse pregnancy outcomes were 0.767, 1.35IU/L, 78.5%, and 72.7%, respectively. Conclusion: The different serum LH levels of the women on the day of HCG injection were negatively correlated with their Gn dosage and the days of Gn used, and the serum LH level of the women has high value for evaluating their adverse pregnancy outcomes. During the superovulation process of the long-term regimen of the women with IVF-ET, the low level of serum LH on the day of HCG injection has a certain extent to increase the dosage and days of Gn used, reduce the pregnancy rate, and increase the early miscarriage rate, which will cause adverse influence on the outcomes of these women.
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