protocol (fsh vs fsh/lh)
5 Replies
LS2005 - September 9

Why do some clinics use just FSH during stimms and others us a combo of FSH/LH? Do some people need to add a little LH to help mature the eggs?


B. Jacobs, M. D. - September 10

Over the years, we found we got better quality eggs and embryos if we did not add extra LH. In our non-IVF cycles, our pregnancy rates are better if we do not add the extra LH. I cannot speak for the programs which do use LH.
Good luck.


Lila - September 11

In your answer you stated that in your non IVF you have improved results with pure FSH - I thought in the past you had said that you also used FSH only protocols for you IVF cycles is that correct? Do you see the same improved results in IVF as non IVF?

I am also curious about her original question why use an FSH only protocol? I understand inproved results at a clinic are sort of the "proof in the pudding" but can you give more specifics about what type of patient benefits from excluding LH? What exactly about one patient would make an RE choose to do only FSH and on another choose FSH with some LH added in?

Thanks you for your time and expertise.


anjabelle - November 27

Hi Lila -- I was wondering if you'd ever heard back from anyone regarding your last post. I just posted a similar question.

Please let me know if you have a chance.


B. Jacobs, M. D. - November 28

We get better eggs, embryos and pregnancy rates if we do not add more LH. We seem to be in the minority.


lms2006 - December 2

lila, anjabelle.....
I had poor fert with ICSI my first two IVF cycles (dx:male factor only). I am 30yrs old and stimmed on 225U FSH only with the long lupron protocol for both cycles. 5 fert of 15 mature eggs and then 3 fert of 11 mature about the same fert rate for both cycles at 30%. Our embryos didn't grow that well and were mostly grade 3. It was so dissapointing. My RE suggested donor this and donor that. Also said a change in protocol would probably not make a difference. I left that RE and found one who believed a change could definitely make a difference....we added in LH 75U with the long lupron protocol. I stimmed on 225U FSH and 75U LH and had 9 fertilize of 14! 64% fert rate!! Not optimal...but much much better! Our embryos also grew better I had 2 8 cells (grade 1), 2 9 cells (grade 2), 1 10 cell (grade 2), 1 7 cell (grade 2) and a few others not doing as well.
A tweak in protocol can make a huge difference!!!!! I am in the we will see... but I am very encouraged about our improved results!!!!!!!!
From what I have read...most people do fine with FSH only (long lupron), but some people need the extra LH. It also depends on the RE told me that with the long lupron you need some extra LH because the lupron can cut the LH to zero....



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