Middle East Fertility Society Journal · Published 2026-07-15 · DOI 10.1186/s43043-026-00351-z
Reham Abdelhamed Elsaid, Hoda Sibai, Amany M Abdelghany, Shahenda A Saleh, Eman Amin Elgindy
Abstract Background The short LH surge induced by a GnRH agonist (GnRHa) trigger minimizes the risk of ovarian hyperstimulation syndrome (OHSS), but its sufficiency to support optimal outcomes remains uncertain. This prospective cohort study evaluated the impact of pre- and post-trigger LH levels on the stimulation outcomes of GnRHa-triggered ICSI cycles. Methods Ninety-four women (≤ 40 years) undergoing GnRHa-triggered ICSI with a freeze-all approach were included. Ovulation was triggered using 0.3 mg triptorelin followed by 0.2 mg after 12 h. LH was measured on the trigger day and 12 h post-trigger. The primary outcome was oocyte maturation rate; secondary outcomes included fertilization and blastulation rates. Data were analyzed using Mann–Whitney, Pearson correlation and ROC curve analysis. Results Pre-trigger LH levels correlated with blastulation rates with modest predictive ability (AUC = 0.67). While post-trigger LH levels correlated significantly with oocyte maturation with modest predictive ability (AUC = 0.70). No significant associations were found with fertilization outcomes. Pre- and post-trigger LH levels were positively correlated (r = 0.36,p = 0.01). Conclusions In GnRHa-triggered ICSI cycles, post-trigger LH levels were associated with oocyte maturation, while pre-trigger LH levels were associated with blastulation rate. However, discriminative performance was modest, and post-trigger LH data were available only in a subset of patients. These findings should be considered exploratory and require validation in larger prospective cohorts before clinical application.
Abstract from DOAJ. Public domain (CC0 1.0).
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Elsaid, R., Sibai, H., Abdelghany, A., et al. (2026). The association of LH level on the stimulation outcomes of ICSI cycle triggered by GnRH agonist: a prospective cohort study. Middle East Fertility Society Journal. https://doi.org/10.1186/s43043-026-00351-z