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The following is a summary of “Clinical impact of endogenous luteinizing hormone in frozen–thawed embryo transfer during hormone replacement cycle without gonadotropin-releasing hormone analog coadministration: Effects on pregnancy outcomes,” published in the December 2024 issue of Obstetrics and Gynecology by Sakata et al.  

Frozen–thawed embryo transfer (FET) during hormone replacement therapy (HRT) is a standard treatment in fertility care. However, the role of luteinizing hormone (LH) in the absence of gonadotropin-releasing hormone (GnRH) analogs remains underexplored.  

Researchers conducted a retrospective study to assess how LH levels influence pregnancy outcomes in individuals undergoing FET during HRT without GnRH analogs.  

They analyzed 490 FET cycles performed (March 2018 and May 2023). Individuals were grouped into quartiles based on LH levels measured before luteal replacement. Multivariate logistic regression analysis evaluated clinical pregnancy and live birth rates as dependent variables. Independent variables included participants’ mean age, LH and estradiol levels, and endometrial thickness at the time of embryo transfer.  

The results showed that the average participant age was 36.8 ± 0.2 years, serum estradiol levels were 306.5 ± 7.7 pg/mL, and LH levels were 10.3 ± 0.3 mIU/mL before luteal replacement. Clinical pregnancy and live birth rates were 46.8% and 31.9%, respectively, and the rates differed significantly across quartiles. Multivariate analysis revealed that younger age and higher LH levels were associated with increased clinical pregnancy and live birth rates.  

They concluded that LH may improve pregnancy outcomes in individuals undergoing FET during HRT without GnRH analogs by enhancing endometrial receptivity for implantation.  

Source: obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/jog.16176