The effect of human chorionic gonadotrophin injection day serum luteinizing hormone level on pregnancy outcome
Li Fuxia1，Fan Huarui1，Hu Guiyu2，Sheng Yan1
1Department of Female Assisted Reproduction, Reproductive Hospital Affiliated to Shandong University, Jinan 250021,China; 2Department of Center for Blood Purification, the Second Hospital of Shandong University,Jinan 250031,China
Abstract：ObjectiveTo discuss the effect of human chorionic gonadotropin (HCG) injection day serum luteinizing hormone (LH) levels on pregnancy outcome in women undergoing in vitro fertilization-embrgo transfer (IVF-ET) with long protocols. MethodsA retrospective study including 1461 cases was performed in reproductive center affiliated to Shandong University from January 2016 to December 2017. Serum LH levels were measured on the day of HCG administration. Two groups were divided according to the ROC curve between serum LH levels and pregnancy outcome， the LH≤1.58IU/L in group A and LH＞1.58IU/L in group B. The Logistic regression was used to analyze the relationship between the total dose, duration of gonadotropin (Gn) and the clinical pregnancy rate. ResultsThe duration of Gn in group A was （11.28±2.46）d, which was longer than that in the group B［（9.92±2.09）d］, and the difference was statistically significant (t=8.99, P＜0.01). The total dose of Gn in group A was （2322.13±1054.77）IU, which was higher than that in the group B［（1789.85±692.51）IU］, and the difference was statistically significant (t=8.60, P＜0.01). The clinical pregnancy rate of group A （61.8%，201/325） was lower than that in group B（69.7%，792/1136）, and the difference was statistically significant (χ2=7.21, P＜0.01). The early abortion rate of group A (11.9%，24/201) was lower than that in group B（6.7%，53/792）, and the difference was statistically significant (χ2=5.37, P＜0.05). According to the Logistic regression, neither the duration of Gn （B=-0.005,wald χ2=0.052, OR=0.995,P＞0.05）， nor the total dose of Gn(B=0.000，wald χ2=0.000，OR=1.000,P＞0.05) was the independent risk factors for clinical pregnancy rate. ConclusionsDuring long protocol, for the patients with the LH levels less than 1.58IU/l on the day of HCG administration, the duration of Gn extended, the total dose increase, and it will lead to the lower pregnancy and higher early abortion rate. The total dose, and duration of Gn are uncorrelated with the clinical pregnancy rate.
