Evaluation of Recombinant Follicle-Stimulating Hormone (rFSH) Plus Recombinant Luteinizing Hormone (rLH) and rFSH Plus Human Menopausal Gonadotropin (HMG) Combination Therapies in Patients With Poor Ovarian Response Undergoing Ovarian Stimulation

Objective: This study aimed to compare the clinical and laboratory outcomes of recombinant follicle-stimulating hormone (rFSH) plus recombinant luteinizing hormone (rLH) and rFSH plus human menopausal gonadotropin (HMG) combination therapies during controlled ovarian hyperstimulation (COH) in patients with poor ovarian response, with the live birth rate defined as the primary clinical endpoint. Methods: This retrospective study included 90 patients who were diagnosed with poor ovarian response based on the Bologna criteria (which were also categorized as Poseidon Groups 3 and 4) and who met the inclusion requirements. Patients were divided into two groups based on the gonadotropin combination used: rFSH+rLH (n=49) and rFSH+HMG (n=41). Stimulation parameters, number of oocytes retrieved, embryo quality, and live birth rates were analyzed and compared. Results: No statistically significant differences were found between the groups regarding age, hormone levels, antral follicle count (AFC), duration of COH, number of retrieved oocytes, M2 oocyte ratio, fertilization rate, or live birth rates (p>0.05). Conclusion: Our findings suggest that both rFSH+rLH and rFSH+HMG combinations yielded similar clinical and laboratory outcomes in patients with diminished ovarian reserve. Given the observational nature of this study, these results should be interpreted with caution, and treatment protocols should remain individualized.