Luteinizing Hormone Levels as an Indicator of the Timing of Antagonist Administration in a Gonadotropin-Releasing Hormone Antagonist Protocol

Background & Objective: Gonadotropin-releasing hormone acts on the anterior pituitary and promotes the release of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH), both of great importance in the ovarian cycle.Materials & Methods: In a prospective cross-sectional study conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies / Al-Nahrain University and Kamal Al-Sameraie Hospital for Infertility and In Vitro Fertilization, Baghdad, Iraq during the period from April ۲۰۲۲ to April ۲۰۲۳, women received rFSH in a single daily dose of (۱۵۰-۳۰۰ IU) for ovarian stimulation. Women in groups B and C received ovarian stimulation antagonists, while those in group A did not.Results: Both clinical and ongoing pregnancy rates were measured for each group. A positive hCG test was found in ۲۷ (۷۹.۴%) in Group A while it was positive in ۱۹ (۵۵.۹%) in Group B with a significant difference (P=۰.۰۳), clinical pregnancy was ۲۵ (۷۳.۵%) in Group A while it was positive in ۱۷ (۵۰.۰%) in Group B with a significant difference (P=۰.۰۴), and ongoing pregnancy was found in ۲۴ (۷۰.۶%) in Group A while it was positive in ۱۵ (۴۴.۱%) in Group B with significant difference (P=۰.۰۱).Conclusion: Women with LH <۴ IU presented with a significantly higher pregnancy rate than those with ≥۴ IU, and do not need GnRH antagonist addition as co-treatment.