Is there a need for Luteinizing Hormone (LH) estimation in patients undergoing ovarian stimulation with gonadotropin-releasing hormone antagonists and recombinant follicle-stimulating hormone?

Aim: To find out effect of serum luteinizing hormone (LH) levels on Day1 (Day 2 of cycle) and Day 5 of stimulation and Day of trigger hCG in controlled ovulation stimulation with antagonist protocol of IVF-ICSI cycle on cycle outcome. Materials and methods: This retrospective study was conducted in a University Hospital setting. One hundred and sixty two patients underwent 165 cycles of controlled ovarian stimulation (COS) with recombinant Follicle stimulating hormone (rFSH) and Gonadotropin releasing hormone (GnRH) antagonist protocol in one year were included. Serum LH levels estimated on Day1, Day 5 and the day of trigger hCG injections were divided into three groups based on the percentile and outcome measured. R esults: The average number of follicles >18 mm in size were significant in the patients with LH levels between 25th to 75th percentile group on D1, D5 and Day of trigger hCG. The fertilization rate was significant (p= 0.04) in the patients with LH levels < 25thpercentile on the day of trigger hCG. Oocyte recovery rate, oocyte maturation rate and average number of best quality embryos (Grade 1) were not affected significantly in all 3 groups. C onclusion: In GnRH antagonist and rFSH protocols, low serum LH concentrations on the day of trigger hCG has better fertilization rate. LH levels between 25th and 75th percentile have an influence on the average number of > 18 mm size follicles. However, the LH level on day 1, day 5 and day of hCG does not affect the cycle outcome in controlled ovarian stimulation with antagonist protocol of IVF cycle. Hence, LH estimation is not mandatory in ART cycles with GnRH antagonist protocol.