Objective  To investigate the effect of GnRH antagonist combined with recombinant luteinizing hormone (rLH) on ovarian responsiveness and IVF pregnancy outcomes in patients with low LH during follicular phase.

Methods  A retrospective analysis was conducted in patients with low LH levels during follicular phase at the Reproductive Medicine Center of Jinhua People's Hospital from January 2022 to December 2023. Patients were divided into a combination intervention group (GnRH antagonist+rLH) and a control group (GnRH antagonist only) based on whether rLH was used. Reproductive endocrine hormone indicators, ovarian morphology, ovarian responsiveness parameters (FORT, FOI, and OSI), pregnancy outcomes, and safety were observed.

Results  A total of 109 patients were included, with 66 in the combination intervention group and 43 in the control group. On the day of human chorionic gonadotropin injection, the combination intervention group showed significantly higher levels of FSH, LH, E2, and progesterone compared to the control group (P<0.05), while AMH, PRL, and testosterone levels showed no significant differences (P﹥0.05). The combination intervention group demonstrated significantly higher FORT, FOI, and OSI than the control group (P<0.05). The combination intervention group had significantly better outcomes in terms of oocyte yield, mature oocyte count, embryo formation, high-quality embryo count, and endometrial thickness on transfer day compared to the control group (P<0.05), but no significant differences were observed in clinical pregnancy rate, biochemical pregnancy rate, or early miscarriage rate (P﹥0.05). The incidence of adverse reactions was no significant difference between the two groups (P ﹥0.05).

Conclusion  The combined application of GnRH antagonist and rLH in IVF for patients with low LH during follicular phase can not only significantly improve ovarian responsiveness, increase the number of oocytes retrieved and embryo quality, but also has a good safety.

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