The DOI matches its Crossref record; 15 of the 15 references it cites were found in a registry or an index.
Increased risk of early pregnancy loss by profound suppression of luteinizing hormone during ovarian stimulation in normogonadotrophic women undergoing assisted reproduction
Abstract
The impact of suppressed concentrations of circulating luteinizing hormone (LH) during ovarian stimulation on the outcome of in-vitro fertilization or intracytoplasmic sperm injection treatment in 200 consecutive, normogonadotrophic women (couples) was analysed retrospectively. A standard stimulation protocol with mid-luteal gonadotrophin-releasing hormone (GnRH) agonist down-regulation and ovarian stimulation with recombinant follicle stimulating hormone (FSH) was used in all cases. Blood was sampled from each woman on stimulation days 1 and 8 for analysis of oestradiol and LH in serum. A threshold value of serum LH of 0.5 IU/l on stimulation day 8 (S8) was chosen to discriminate between women with low or 'normal' LH concentrations. Low concentrations of LH on S8 (<0.5 IU/l) were found in 49% (98/200) of the women. This group of women was comparable with the normal LH group with regard to pre-treatment clinical parameters, and to the parameters characterizing the stimulation protocol with the exception of serum oestradiol concentration, which on S8 was significantly lower than in the normal LH group (P < 0.001). The proportion of positive pregnancy tests was similar in the two groups (30% versus 34% per started cycle), but the final clinical treatment outcome was significantly different, with a five-fold higher risk of early pregnancy loss (45% versus 9%; P < 0.005) in the low LH group and consequently a significantly poorer chance of delivery than in the normal LH group. It is concluded that a substantial proportion of normogonadotrophic women treated with GnRH agonist down-regulation in combination with FSH, devoid of LH activity, experience LH suppression, which compromises the treatment outcome. Whether these women would benefit from supplementation with recombinant LH or human menopausal gonadotrophin during ovarian stimulation, remains to be proven in the future by prospective randomized trials.
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“no evidence in the literature directly links hypogonadotropism to delayed parturition and periparturient mortality19–22.”
From Conditional loss of ERK1 and ERK2 results in abnormal placentation and delayed parturition in the mouse (2019) · cites this paper as [20]
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Cites
Chappel, S. C., & Howles, C. M. (1991) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a137513 · Cited by 280
Tesařík, J., & Mendoza, C. (1995) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.80.4.7714121 · Cited by 247
The role of luteinizing hormone in folliculogenesis and ovulation induction
Filicori, M. (1999) · Fertility and Sterility · doi:10.1016/s0015-0282(98)00482-8 · Cited by 171
Shoham, Z., Balen, A. H., Patel, A. K., & Jacobs, H. S. (1991) · Fertility and Sterility · doi:10.1016/s0015-0282(16)54715-3 · Cited by 170
Fleming, R., Lloyd, F., Herbert, M., Fenwick, J., Griffiths, T., & Murdoch, A. P. (1998) · Human Reproduction · doi:10.1093/humrep/13.7.1788 · Cited by 160
Balasch, J., Miró, F., Burzaco, I., Casamitjana, R., Cı́vico, S., Ballescà, J. L., Puerto, B., & Vanrell, J. A. (1995) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a136154 · Cited by 151
Loumaye, E., Engrand, P., Howles, C. M., & O'Dean, L. (1997) · Fertility and Sterility · doi:10.1016/s0015-0282(97)81402-1 · Cited by 142
Andersen, C. Y. (1993) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.77.5.7521343 · Cited by 137
Studies of the mechanism(s) of mammalian ovulation
Yoshimura, Y., & Wallach, E. E. (1987) · Fertility and Sterility · doi:10.1016/s0015-0282(16)49931-0 · Cited by 114
Apter, D. L., Cacciatore, B., Alfthan, H. V., & Stenman, U. (1989) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-68-1-53 · Cited by 110
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The Science behind 25 Years of Ovarian Stimulation for in Vitro Fertilization
Macklon, N., Stouffer, R. L., Giudice, L. C., & Fauser, B. C. J. M. (2006) · Endocrine Reviews · doi:10.1210/er.2005-0015 · Cited by 572
Humaidan, P., Bredkjær, H. E., Bungum, L. J., Bungum, M., Grøndahl, M. L., Westergaard, L. G., & Andersen, C. Y. (2005) · Human Reproduction · doi:10.1093/humrep/deh765 · Cited by 484
Self-citationEvidence-based investigations and treatments of recurrent pregnancy loss
Christiansen, O. B., Andersen, A. N., Bosch, E., Daya, S., Delves, P. J., Hviid, T. V. F., Kutteh, W. H., Laird, S. M., Li, T. C., & van der Ven, K. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.12.018 · Cited by 303
Reproductive biology and IVF: ovarian stimulation and luteal phase consequences
Fauser, B. C. J. M., & Devroey, P. (2003) · Trends in Endocrinology and Metabolism · doi:10.1016/s1043-2760(03)00075-4 · Cited by 244
The European Middle East Orgalutran® Study Group (2001) · Human Reproduction · doi:10.1093/humrep/16.4.644 · Cited by 241
Metadata
- Authors
- Westergaard, L. G.
- Affiliations
- Odense University Hospital (DK)
- Corresponding author
- Westergaard, L. G.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2000-05-01
- Volume
- 15
- Issue
- 5
- Pages
- 1003-1008
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2131053749
- Cited by
- 301
- References
- 15
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 6 · 2023: 5 · 2022: 16 · 2021: 12 · 2020: 3 · 2019: 8 · 2018: 4 · 2017: 8 · 2016: 11 · 2015: 12 · 2014: 12 · 2013: 7 · 2012: 11
- FWCI
- 15.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- luteinizing hormone suppression, early pregnancy loss, ovulation induction, in vitro fertilization, intracytoplasmic sperm injection, GnRH agonist down-regulation, recombinant FSH, estradiol
- MeSH terms
- Abortion, Spontaneous, Adult, Estradiol, Female, Fertilization in Vitro, Follicle Stimulating Hormone, Gonadotropins, Humans, Luteinizing Hormone, Gonadotropin-Releasing Hormone, Luteal Phase, Ovary, Ovulation Induction, Pregnancy, Recombinant Proteins, Reference Values, Retrospective Studies, Treatment Outcome, Sperm Injections, Intracytoplasmic
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