Uso do hormônio luteinizante recombinante em ciclos de fertilização assistida
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Data
2015-12-03
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Universidade Federal de Goiás
Resumo
Controlled ovarian stimulation has become an integral part of
infertility treatment. Treatment options with recombinant gonadotrophins add
more to knowledge on folliculogenesis and ovarian steroidogenesis. The role
of recombinant luteinizing hormone is controversial undergoing ovarian
stimulation and has been widely debated. Objective: To compare the effects
of supplementation with recombinant luteinizing hormone (rLH) for controlled
ovarian stimulation with recombinant follicle stimulating hormone (rFSH) in a
protocol with GnRH-antagonist in cycles of IVF/ICSI. Methods: Case-control
study with 113 patients attended at a university center in the city of Goiania,
aged between 34-42 years, who were divided into two groups according to
an ovarian stimulation scheme: Group I (n= 60): rFSH (control group) and
Group II (n= 53): rFSH + rLH (treated group). These groups were comparable
for age, BMI, duration of infertility, serum FSH, LH and estradiol. Numbers of
oocytes collected and in metaphase II, fertilization rate, embryos rate and
rates of chemical and clinical pregnancy were analyzed. Data analysis was
conducted using the statistical software BioStat ® 5.3. Differences in
proportions were assessed by chi-square test and means by Wilcoxon Mann-
Whitney test. P < 0,05 was considered statistically significant. Results: The
mean age of patients in Group I was 37.3±2.1 years and Group II 37.9±2.4
years (P > 0.05). The comparability of the other main characteristics
(duration of infertility, BMI, FSH, LH and basal estradiol) were also observed
between Groups I and II (P > 0.05). There was no significant difference
between the two groups regarding: number of oocytes retrieved (Group I=
4.9 ± 2.1, Group II= 5.7 ± 2.6, P= 0.061), number of oocytes in metaphase II
(Group I= 3.4 ± 1.6, Group II= 4.0 ± 1.9, P= 0.060), fertilization rate (Group I=
65.3%, Group II= 69.4 %, OR 1.20, 95% CI 0.85-1.70, P= 0.282), embryos
rate (Group I= 85.4%, Group II= 88.5%, OR 1.31, 95% CI 0.73-2.36, P=
0.355), rate of chemical pregnancy (Group I= 20.0%, Group II= 24.5%; OR
1.30, 95% CI 0.53-3.16, P= 0.562) and clinical pregnancy rate (Group I=
20.0%, Group II= 22.6%, OR 1.17, 95% CI 0.47-2.89, P= 0.731).
Conclusion: In this study it was concluded that supplementation with r-LH
showed no benefit with respect to variables during controlled ovarian
stimulation with GnRH antagonists.
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Citação
MAIA, M. C. S. Uso do hormônio luteinizante recombinante em ciclos de fertilização assistida. 2015. 101 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2015.