המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-16 17:24:31 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) – Recombinant human luteinizing hormone (rhLH) appears to be safer than urinary human chorionic gonadotropin (u-hCG) and just as effective in inducing follicular maturation and ovulation for vitro fertilization (IVF), researchers from the European Recombinant LH Study Group report.
Dr. E. Loumaye from Serono International in Geneva and colleagues randomly assigned 259 infertile women, 18 to 39 years of age, to receive either rhLH or u-hCG. The primary study endpoint was the number of oocytes retrieved with each therapy.
Women receiving rhLH were given doses of 5000 IU, 15,000 IU, 30,000 IU or 15,000 IU plus an additional 10,000 IU given 3 days after the initial injection. All women receiving u-hCG received 5000 IU.
The researchers found that the number of oocytes retrieved did not differ significantly between the two groups. Among the women receiving rhLH, no significant difference in the number of oocytes was seen with the different doses. There was also no statistically significant difference in the number of oocytes retrieved per follicle with a diameter over 10 mm on the day of u-hCG or rhLH administration.
In addition, the researchers observed no significant differences between the two drugs in the number of women who had at least one oocyte retrieved, oocyte maturity, oocyte potential for fertilization, the number of embryos, the number of total biochemical and clinical pregnancies and embryo implantation rate.
However, "the lowest dose of rhLH seemed suboptimal compared with higher doses," Dr. Loumaye's group reports in the June issue of The Journal of Clinical Endocrinology and Metabolism. The researchers note that rhLH was well tolerated up to the maximum dose.
Moderate ovarian hyperstimulation syndrome occurred in 12.4% of the u-hCG patients and in 12.0% of the patients who received two injections of rhLH. However, there were no cases of moderate or severe ovarian hyperstimulation syndrome among the women who received a single injection of rhLH.
"Based on this study, the recommended dose of rhLH is a single administration of at least 15,000 IU or 30,000 IU," Dr. Loumaye and colleagues advise. "This dose, they say, "will provide an efficacy at least equivalent to that of the reference treatment of 5000 IU u-hCG and a safety superior to that of u-hCG, particularly with respect to the incidence of ovarian hyperstimulation syndrome."
J Clin Endocrinol Metab 2001;86:2607-2618.
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