Effects of Luteinizing Hormone Supplementation on Ovarian Response and Assisted Reproductive Technology Outcomes in Antagonist In vitro Fertilization/Intracytoplasmic Sperm Injection Cycles: A Meta-analysis

Objective: The study objective was to investigate the effects of luteinizing hormone (LH) supplementation on ovarian response and assisted reproductive technology(ART) outcomes in in vitro fertilization/ intracytoplasmic sperm injectioncycles with a gonadotropin (Gn)-releasing hormone antagonistprotocol. Methods: This is a meta-analysis, and nine published randomized controlled trials (1,685 patients) were included. Continuous data were extracted in the form of mean ± standard deviation and population size, whereas dichotomous data were extracted in the form of odds ratio. Results: The total amount of follicle-stimulating hormone(FSH) used, the duration of stimulation (DOS), the number of eggs in MII stage, the total number of formed embryos, the clinical pregnancy rate, and live birth rates were similar between groups, but the estrogen level on the day of human chorionic Gn (hCG) administration was slightly higher in the LH supplementation group. On subgroup analysis, it was reported that the addition of LH could significantly increase estrogen levels on the day of hCG administration in patients older than 35 years, and LH supplementation starting on the day of FSH administration may slightly extend the DOS. Moreover, regardless of the timing of LH supplementation, an increase in estrogen levels was found on the day of hCG administration. Conclusions: LH supplementation of an antagonist protocol increases estrogen levels on the day of hCG administration, but does not increase the number of mature oocytes retrieved, and also fails to improve ART outcomes.