Does premature luteinization or early surge of LH impair cycle outcome? Report of two successful outcomes

Abstract

Purpose: To report two successful antagonist IVF cycles; one ending up with pregnancy despite premature luteinization (case 1, aged 35 years), and the other with the retrieval of high quality oocytes despite premature ovulation (case 2, aged 39 years).

Methods: Serum LH was 36 and 47 IU/L on cycle day 7 before antagonist administration, which was then brought to 6.94 and 3.92 IU/L by antagonist administration, and kept below these levels throughout the remaining stimulation in case 1 and 2 respectively. Serum progesterone was 1.42 and 5.5 ng/mL on the day of hCG respectively. Ten metaphase II (MII) oocytes were harvested wherein 3 grade A embryos were transferred in case 1, and seven good quality MII oocytes were retrieved wherein six embryos were cryopreserved in case 2.

Conclusions: More precise cut thresholds for both LH and progesterone are necessary for accurate prediction of the cycle outcomes.

Figures

Fig. 1

LH, estradiol and progesterone levels before and after GnRH antagonist administration in case 1

Fig. 2

LH, estradiol and progesterone levels before and after GnRH antagonist administration in case 2. The increase in progesterone showed ovulation; embryo transfer was cancelled and the embryos were cryopreserved