Amaç: GnRH antagonisti stimülasyonu ve taze embriyo transferi uygulanan hastalarda hCG trigger gününde LH seviyeleri ile üreme sonuçları arasındaki ilişkiyi araştırmak. Gereç ve Yöntemler: Ocak 2015 ile Aralık 2022 arasında üniversite merkezli bir infertilite kliniğinde retrospektif kesitsel bir çalışma yürütüldü. Çalışmaya, GnRH antagonisti protokolü kullanılarak taze, donör olmayan intrasitoplazmik sperm enjeksiyonu (ICSI) veya in vitro fertilizasyon (IVF) tedavi döngüleri uygulanan 40 yaş ve altı normoresponder kadınlar dahil edildi. Bulgular: Bu çalışmaya 105 hasta dahil edildi. Bunlardan 41'i canlı doğum yaptı. Canlı doğum yapan ve yapmayan hastalar arasında hCG trigger gününde yaş ve serum LH seviyeleri açısından anlamlı farklılıklar gözlendi, ancak trigger gününde progesteron seviyeleri, alınan oosit sayısı, embriyo kalitesi veya olgun (MII) oosit sayısı açısından anlamlı bir fark görülmedi. ROC analizi, optimum duyarlılık ve özgüllük ile 2,7 mUI/ml'lik bir LH eşiği belirledi. İleri kadın yaşı, gebelik başarısızlık oranını anlamlı ölçüde artıran bir risk faktörü olarak görüldü (Gebelik: RR=1,1, %95 CI=1,014-1,194, p=0,022; Canlı Doğum: RR=1,082, %95 CI=0,997-1,174, p=0,06). Yaşa göre ayarlanmış çok değişkenli regresyon analizi, düşük LH seviyelerine sahip hastalarda (≤2,7 mUI/ml) gebelik oranlarında 4,7 kat (95% CI=1,929-11,44, p=0,001) ve canlı doğum oranlarında 4,1 kat (95% CI=1,730-9,706, p=0,001) düşüş olduğunu ortaya koydu. Sonuç: hCG trigger gününde 2,7 mIU/ml'lik bir LH eşiği, başarısız gebelik sonuçlarını tahmin etmek için kullanılabilir. Trigger gününde düşük LH seviyelerine sahip normoresponder kadınlar için bir freeze-all stratejisi ihtiyatlı bir tercih olabilir.

Objective: To investigate the association between LH levels on hCG trigger day and reproductive outcomes in patients undergoing GnRH antagonist stimulation followed by fresh embryo transfer. Materials and Methods: A retrospective cross-sectional study was conducted at a university- based infertility clinic between January 2015 and December 2022. The study included normoresponder women aged 40 or younger who underwent fresh, non-donor intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF) treatment cycles using a GnRH antagonist protocol. Results: 105 patients were included in this study. Among them, 41 patients achieved live births. Significant differences in age and serum LH levels on the hCG trigger day were observed between patients who achieved live birth and those who did not, but no significant differences in terms of progesterone levels on trigger day, number of oocytes retrieved, embryo quality, or number of mature (MII) oocytes. The ROC analysis identified an LH threshold of 2.7 mUI/ml with optimal sensitivity and specificity. Older women are at higher risk of unsuccessful pregnancy outcomes (Pregnancy: RR=1.1, 95% CI=1.014-1.194, p=0.022; Live Birth: RR=1.082, 95% CI=0.997-1.174, p=0.06). Age-adjusted multivariate regression analysis revealed a 4.7-fold decrease in pregnancy rates (95% CI=1.929-11.44, p=0.001) and 4.1-fold (95% CI=1.730-9.706, p=0.001) in live birth rates among patients with lower LH levels (≤2.7 mUI/ml). Conclusion: An LH threshold of 2.7 mIU/ml on the hCG trigger day can be used to predict unsuccessful pregnancy outcomes. A freeze-all strategy might be a prudent choice for the normoresponder women with low LH levels on trigger day.

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