Recombinant human luteinizing hormone co-treatment in ovarian stimulation for assisted reproductive technology in women of advanced reproductive age: a systematic review and meta-analysis of randomized controlled trials

Autor: Sandro C. Esteves, Alberto Vaiarelli, Alessandro Conforti, Laura Rienzi, Filippo Maria Ubaldi, Fulvio Zullo, Peter Humaidan, Danilo Cimadomo, Thomas D'Hooghe, Salvatore Longobardi, Carlo Alviggi, Raoul Orvieto
Přispěvatelé: Conforti, A., Esteves, S. C., Humaidan, P., Longobardi, S., D'Hooghe, T., Orvieto, R., Vaiarelli, A., Cimadomo, D., Rienzi, L., Ubaldi, F. M., Zullo, F., Alviggi, C.
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Luteinizing hormone
HUMAN LH SUPPLEMENTATION
QH471-489
medicine.medical_treatment
GNRH-ANTAGONIST PROTOCOL
Review
Miscarriage
law.invention
0302 clinical medicine
Endocrinology
Randomized controlled trial
DOWN-REGULATED WOMEN
law
In vitro fertilization
Randomized Controlled Trials as Topic
Reproductive Biology
030219 obstetrics & reproductive medicine
Obstetrics
Reproduction
Obstetrics and Gynecology
Recombinant Protein
Assisted reproductive technology
Combined Modality Therapy
Recombinant Proteins
INTERNATIONAL COMMITTEE
Female
WORLD REPORT
Live birth
Life Sciences & Biomedicine
Human
Adult
medicine.medical_specialty
Reproductive Techniques
Assisted
Recombinant luteinizing hormone
Reproductive medicine
FOLLICULAR-FLUID
IMPLANTATION FAILURE
Subgroup analysis
03 medical and health sciences
Endocrinology & Metabolism
Ovulation Induction
medicine
Humans
NORMOGONADOTROPHIC WOMEN
CYCLE DUOSTIM
In vitro fertilisation
Science & Technology
business.industry
Odds ratio
Gynecology and obstetrics
medicine.disease
030104 developmental biology
Reproductive Medicine
Advanced reproductive age
RG1-991
business
IN-VITRO FERTILIZATION
Developmental Biology
Zdroj: Reproductive Biology and Endocrinology, Vol 19, Iss 1, Pp 1-14 (2021)
Conforti, A, Esteves, S C, Humaidan, P, Longobardi, S, D’Hooghe, T, Orvieto, R, Vaiarelli, A, Cimadomo, D, Rienzi, L, Ubaldi, F M, Zullo, F & Alviggi, C 2021, ' Recombinant human luteinizing hormone co-treatment in ovarian stimulation for assisted reproductive technology in women of advanced reproductive age : a systematic review and meta-analysis of randomized controlled trials ', Reproductive Biology and Endocrinology, vol. 19, 91 . https://doi.org/10.1186/s12958-021-00759-4
Reproductive Biology and Endocrinology : RB&E
ISSN: 1477-7827
Popis: Introduction Several studies suggest that luteinizing hormone (LH) could improve IVF outcome in women of advanced reproductive age by optimizing androgen production. In this review, we assessed the role of recombinant-human LH (r-hLH) and recombinant human follicle stimulating hormone (r-hFSH) co-treatment in ovarian stimulation for assisted reproductive technology in women of advanced reproductive age candidates for assisted reproduction. Material and methods Using a preregistered protocol we systematically searched Medline/PubMed, Scopus and the ISI Web of Science databases to identify randomized controlled trials in which r-hFSH monotherapy protocols were compared with r-hFSH/r-hLH co-treatment in women ≥35 years undergoing fresh IVF cycles. We calculated the pooled odds ratio (OR) for dichotomous data and the weight mean difference (WMD) for continuous data with an associated 95% confidence interval (CI). The meta-analyses were conducted using the random-effect model. P values Results Twelve studies were identified. In women aged between 35 and 40 years, r-hFSH/r-hLH co-treatment was associated with higher clinical pregnancy rates (OR 1.45, CI 95% 1.05–2.00, I2 = 0%, P = 0.03) and implantation rates (OR 1.49, CI 95% 1.10–2.01, I2 = 13%, P = 0.01) versus r-hFSH monotherapy. Fewer oocytes were retrieved in r-hFSH/r-hLH-treated patients than in r-hFSH-treated patients both in women aged ≥35 years (WMD -0.82 CI 95% -1.40 to − 0.24, I2 = 88%, P = 0.005) and in those aged between 35 and 40 years (WMD -1.03, CI − 1.89 to − 0.17, I2 = 0%, P = 0.02). The number of metaphase II oocytes, miscarriage rates and live birth rates did not differ between the two groups of women overall or in subgroup analysis. Conclusion Although more oocytes were retrieved in patients who underwent r-hFSH monotherapy, this meta-analysis suggests that r-hFSH/r-hLH co-treatment improves clinical pregnancy and implantation rates in women between 35 and 40 years of age undergoing ovarian stimulation for assisted reproduction technology. However, more RCTs using narrower age ranges in advanced age women are warranted to corroborate these findings.
Databáze: OpenAIRE
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