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Is the use of r-FSH and r-LH advantageous in comparison with r-FSH treatment in ovarian stimulation cycles?
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Resumo(s)
There is an increase of couples suffering from infertility, and many resort to assisted reproductive techniques. One of its main components is the ovarian stimulation, however, there is not a defined goldstandard protocol, as it is defined accordingly with every patient. Moreover, there is not a consensus of which gonadotropins have the most effective results. Therefore, this thesis main goal was to study if recombinant-follicle-stimulating hormone and recombinant-luteinizing hormone combined have advantageous results in comparison with the recombinant-follicle-stimulating hormone alone. Additionally, there was also interest in analysing if urinary-follicle-stimulating hormone and urinaryluteinizing hormone combined have advantageous results in comparison with the recombinant-folliclestimulating hormone alone. To answer these questions, 1436 short antagonist cycles’ laboratory results and clinical outcomes where studied. Data was divided in three main groups with each gonadotropin options. Each group was, then, subdivided into three other groups with the correspondent ovulation trigger administrated (recombinant-human-chorionic gonadotropin, gonadotropin-releasing hormone agonist and dual trigger). The main gonadotropins were analysed solo and interacting with the ovulation triggers. Recombinant-follicle-stimulating hormone alone was found to have higher significant results prior to embryo transfer in most analysed variables, compared with both combined gonadotropins, regardless of their form, as well as a higher live births rate when comparing with the recombinant combined gonadotropins. Moreover, the recombinant-follicle-stimulating hormone with the gonadotropin-releasing hormone agonist was the combination with higher significant results observed prior to embryo transfer regarding most variables, but with no significant differences in post-embryo transfer outcomes. These findings suggest that the luteinizing hormone does not add advantages to the ovarian stimulation protocol, but since there are several authors with contradictory conclusions, additional studies are needed to further confirm these results, namely in women with poor ovarian response/advanced reproductive ages, groups where the luteinizing hormone is mostly described to have an advantageous effect.
Descrição
Tese de Mestrado, Biologia Evolutiva e do Desenvolvimento, 2025, Universidade de Lisboa, Faculdade de Ciências
Palavras-chave
Gonadotropins recombinant-FSH recombinant-LH ovulation trigger short antagonist protocol