A spontaneous luteinizing hormone surge is beneficial in women with unexplained infertility undergoing controlled ovarian hyperstimulation without in vitro fertilization.

Abstract

OBJECTIVE:

To determine whether a spontaneous luteinizing hormone (LH) surge influences the pregnancy and miscarriage rate in women with unexplained infertility undergoing controlled ovarian hyperstimulation (COH) without in vitro fertilization.

DESIGN:

Retrospective cohort study.

SETTING:

Ovulation Induction Clinic, Royal Hospital for Women, Sydney, Australia.

PATIENTS:

145 patients with unexplained infertility who underwent 374 cycles of COH.

METHODS:

Two types of ovarian stimulation protocols were used: human menopausal gonadotrophin (hMG) alone or hMG and clomiphene citrate (CC). A spontaneous LH surge occurred in 54% of the total cycles. All patients received human chorionic gonadotrophin, whether or not a spontaneous LH surge occurred. All cycles were covered by natural intercourse.

MAIN OUTCOME MEASURES:

Cycle pregnancy rate and miscarriage rate in cycles with or without a spontaneous LH surge.

RESULTS:

The cycle pregnancy rate of the LH surge group was significantly higher than that of the no LH surge group for CC/hMG cycles (16.4% and 4.3% respectively, p = 0.02) but not for hMG alone cycles (12.8% and 10% respectively, P > .05). The miscarriage rate was not significantly different between the LH surge group and no LH surge group in either the CC/hMG cycles (30% and 75% respectively, P > .05) or the hMG alone cycles (22% and 38% respectively, P > .05).

CONCLUSIONS:

In women with unexplained infertility undergoing COH with CC/hMG, the occurrence of a spontaneous LH surge is a favorable event associated with a significantly increased pregnancy rate. The data showed a lower miscarriage rate, but there was insufficient power to confirm or refute this result.

• Authors: M F Costello, G J Hughes, D K Garrett, A Hanjani, S J Steigrad
• Journal: International journal of fertility and women's medicine (Int J Fertil Womens Med) 1998 Jan-Feb Vol. 43 Issue 1 Pg. 28-33 ISSN: 1534-892X [Print] United States
• PMID: 9532467 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Fertility Agents, Female
• Clomiphene
• Menotropins
• Luteinizing Hormone

Topics

• Adult
• Clomiphene (therapeutic use)
• Cohort Studies
• Drug Therapy, Combination
• Female
• Fertility Agents, Female (therapeutic use)
• Humans
• Infertility, Female (blood, drug therapy)
• Luteinizing Hormone (blood)
• Menotropins (therapeutic use)
• Ovulation Induction (methods)
• Pregnancy
• Retrospective Studies
• Treatment Outcome