ObjectiveTo investigate whether the timing of rLH addition to rFSH during controlled
ovarian stimulation (COS) impacts ovarian response and the outcomes of
intracytoplasmic sperm injection (ICSI) cycles.MethodsData of 1278 patients undergoing ICSI between 2015 and 2018, in a private
university-affiliated IVF center were analyzed. Patients were divided into
groups according to the timing of LH addition to the COS protocol: Group
LH-start (n=323), in which LH was administered since day 1 of ovarian
stimulation; and Group LH-mid (n=955), in which LH was administered
concomitantly with gonadotropin releasing hormone (GnRH) antagonist. Data
were also stratified according to female age and response to COS. The
outcomes of COS and ICSI were compared between the groups.ResultsFor the general group and in patients aged ≥ 35 years, higher
blastocyst development rates were in Group LH-mid compared to Group
LH-start. In patients with poor response to COS (POR), higher fertilization
rate, blastocyst development rate and implantation rate were observed in
Group LH-mid.ConclusionsrLH supplementation in POR patients may improve laboratorial and clinical
outcomes when started in the mid-follicular phase, in GnRH antagonist ICSI
cycles.