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Geneva, Switzerland
Address all correspondence and requests for reprints to: Ares-Serono Scientific and Medical Communications Department, 15 bis Chemin des Mines, CH-1202 Geneva, Switzerland.
The efficacy of recombinant human LH (rhLH) for supporting human
(rhFSH)-induced follicular development was investigated in
hypogonadotropic hypogonadal women (WHO group I anovulation). Patients
(n = 38) were randomized to receive rhLH (0, 25, 75, or 225
IU/day) in addition to a fixed dose of rhFSH (150 IU/day). rhLH was
found 1) to promote dose-related increases in estradiol
(E2) and androstenedione secretion by rhFSH-induced
follicles, i.e. serum concentrations on the last day of
FSH administration were 65 ± 4, 195 ± 94, 1392 ± 585,
and 2441 ± 904 pmol/L for E2 and 3.6 ± 0.9,
5.1 ± 1.3, 6.4 ± 1.3, and 6.7 ± 1.3 nmol/L for
androstenedione for patients treated with 0, 25, 75, and 225 IU rhLH,
respectively; 2) to increase ovarian sensitivity to FSH, as
demonstrated by the proportion of patients who developed follicles
after the administration of a fixed dose of FSH, i.e. 1
of 8, 3 of 7, 7 of 9, and 8 of 10 in patients treated with 0, 25, 75,
and 225 IU rhLH, respectively; and 3) to enhance the ability of these
follicles to luteinize when exposed to hCG. A daily dose of 75 IU rhLH
was effective in the majority of women in promoting optimal follicular
development (defined as 
1 follicle 17 mm; E2, 400
pmol/L; midluteal phase progesterone, 25 nmol/L) and maximal
endometrial growth. A minority of patients may require up to 225
IU/day. rhLH, given sc at a dose up to 225 IU/day, was not immunogenic
and was well tolerated.
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