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BOOK TITLE: Principles and Practice of Assisted Reproductive Technology
This chapter attempts to understand the rationale behind luteinizing hormone (LH) supplementation during controlled ovarian stimulation, the specific groups that require LH and the various options available for adding LH activity. LH has a really important function in steroidogenesis. It has different roles during the early and the late folliculogenesis, which are explained in this chapter. The LH window is the range of LH level, between the LH threshold and LH ceiling which is when optimal follicular growth occurs. During controlled ovarian stimulation with follicle-stimulating hormone (FSH) only, the endogenous LH is usually adequate to support multiple follicular growth. However, in certain groups, the addition of LH improves the in vitro fertilization (IVF) outcome. The LH activity can be added using gonadotropin preparations like urinary human menopausal gonadotropin (hMG), recombinant LH, and urinary and recombinant human chorionic gonadotropin (hCG).