Purpose <p>To clarify clinical practice with regard to LH requirements and identify patient profiles that could benefit from luteinizing hormone (LH)-follicle-stimulating hormone co-treatment.</p> Methods <p>In a Delphi survey, a scientific advisory board elaborated 28 statements on the role of luteinizing hormone (LH) in folliculogenesis (<i>n</i> = 7 statements), the utility of LH for follicular development prior to ovulation induction/intrauterine insemination protocols (<i>n</i> = 3), the utility of LH for follicular development prior to agonist or pretreated antagonist protocols in IVF (<i>n</i> = 6), the source and type of LH activity (<i>n</i> = 3), and patient profiles (<i>n</i> = 9). These statements were reviewed and clarified by two pilot experts. A panel of 26 French ART experts voted in two rounds. Full consensus and consensus were defined respectively as 100% and &gt; 66% agreement. Statements could be reformulated between the two rounds of voting.</p> Results <p>A full consensus or a consensus was reached for 24 of the 28 statements. All the statements concerning the pathophysiological role of LH in folliculogenesis achieved a consensus. The experts endorsed the basic science and emphasized the need to consider inter-individual variability in the clinic. Recombinant human LH was considered to optimize outcomes in a range of patient profiles: a suboptimal ovarian response to IVF stimulation, desensitization following a long agonist protocol, advanced maternal age (&gt; 35), polymorphisms, low body mass index, and women with hypogonadotropic hypogonadism.</p> Conclusions <p>This Delphi consensus from a representative group of French experts provided real-world guidance on LH’s crucial importance in folliculogenesis and the patient profiles for which LH is beneficial.</p>

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The role of luteinizing hormone in the management of female infertility: A French Delphi consensus

  • Isabelle Cédrin-Durnerin,
  • Julie Labrosse,
  • Claire Castello Bridoux,
  • Valérie de Buyst,
  • Ségolène Paillet,
  • Muriel Lubrano,
  • Théo Cerceau,
  • Stéphane Bouée,
  • Bruno Salle,
  • François Olivennes,
  • Laetitia Jacquesson

摘要

Purpose

To clarify clinical practice with regard to LH requirements and identify patient profiles that could benefit from luteinizing hormone (LH)-follicle-stimulating hormone co-treatment.

Methods

In a Delphi survey, a scientific advisory board elaborated 28 statements on the role of luteinizing hormone (LH) in folliculogenesis (n = 7 statements), the utility of LH for follicular development prior to ovulation induction/intrauterine insemination protocols (n = 3), the utility of LH for follicular development prior to agonist or pretreated antagonist protocols in IVF (n = 6), the source and type of LH activity (n = 3), and patient profiles (n = 9). These statements were reviewed and clarified by two pilot experts. A panel of 26 French ART experts voted in two rounds. Full consensus and consensus were defined respectively as 100% and > 66% agreement. Statements could be reformulated between the two rounds of voting.

Results

A full consensus or a consensus was reached for 24 of the 28 statements. All the statements concerning the pathophysiological role of LH in folliculogenesis achieved a consensus. The experts endorsed the basic science and emphasized the need to consider inter-individual variability in the clinic. Recombinant human LH was considered to optimize outcomes in a range of patient profiles: a suboptimal ovarian response to IVF stimulation, desensitization following a long agonist protocol, advanced maternal age (> 35), polymorphisms, low body mass index, and women with hypogonadotropic hypogonadism.

Conclusions

This Delphi consensus from a representative group of French experts provided real-world guidance on LH’s crucial importance in folliculogenesis and the patient profiles for which LH is beneficial.