{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:02:13Z","timestamp":1784869333527,"version":"3.55.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>\n                    Women with diminished ovarian reserve represent a low-prognosis population in assisted reproduction, in whom improving the efficiency of converting the available antral follicle pool into retrievable oocytes may be clinically relevant. We conducted a retrospective single-center cohort study including 232 IVF\/ICSI cycles (232 women) performed between January 2022 and April 2025 in POSEIDON groups 3\u20134 (anti-M\u00fcllerian hormone &amp;lt;1.2 ng\/mL), comparing a high-dose antagonist regimen preceded by combined oral contraceptive pretreatment plus recombinant luteinizing hormone priming (150 IU\/day for 7 days; LHP,\n                    <jats:italic>n<\/jats:italic>\n                    = 93) with a comparable high-dose antagonist regimen without priming (no-LHP,\n                    <jats:italic>n<\/jats:italic>\n                    = 139). Both groups received fixed high-dose stimulation with recombinant follicle-stimulating hormone (300 IU\/day) plus recombinant luteinizing hormone (150 IU\/day). The primary outcome was ongoing pregnancy at \u226512 weeks. Cycle suspension before oocyte retrieval was less frequent with LHP than with no-LHP (1.1% vs. 10.1%). Follicular efficiency also favored LHP, with higher follicular output rate (59.4% vs. 52.8%) and follicle-to-oocyte index (82.6% vs. 70.9%). In fresh transfers, ongoing pregnancy was higher with LHP per started cycle (18.3% vs. 9.4%) and per embryo transfer (30.4% vs. 15.5%), with a similar trend per oocyte retrieval (18.5% vs. 10.4%). In multivariable logistic regression analyses, LH priming remained independently associated with ongoing pregnancy after adjustment for age, body mass index, and anti-M\u00fcllerian hormone, with consistent effect estimates across models (odds ratio range 2.20\u20132.41). Combined first-transfer ongoing pregnancy, defined as the fresh transfer or, when no fresh transfer occurred, the first subsequent frozen embryo transfer derived from the same stimulation cycle, also showed a favorable trend (29.7% vs. 17.0%). On updated follow-up, all pregnancies that had reached the ongoing stage in both groups resulted in live birth. In low-prognosis women, a COC-based recombinant luteinizing hormone priming protocol within a high-dose antagonist framework was associated with improved follicular efficiency, fewer pre-retrieval suspensions, and higher ongoing pregnancy rates in fresh cycles. Prospective studies are warranted to confirm these findings and better define patient selection.\n                  <\/jats:p>","DOI":"10.3389\/fendo.2026.1877719","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:24:51Z","timestamp":1784867091000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Recombinant LH priming improves follicular efficiency and pregnancy outcomes in women with diminished ovarian reserve undergoing antagonist IVF stimulation"],"prefix":"10.3389","volume":"17","author":[{"given":"Diletta","family":"Guglielmi","sequence":"first","affiliation":[{"name":"Biogenesi, Reproductive Medicine Centre","place":["Monza, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio Maurizio Maria","family":"Brigante","sequence":"additional","affiliation":[{"name":"Biogenesi, Reproductive Medicine Centre","place":["Monza, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Gippone","sequence":"additional","affiliation":[{"name":"Biogenesi, Reproductive Medicine Centre","place":["Monza, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Iemmello","sequence":"additional","affiliation":[{"name":"Biogenesi, Reproductive Medicine Centre","place":["Monza, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariabeatrice","family":"Dal Canto","sequence":"additional","affiliation":[{"name":"Biogenesi, Reproductive Medicine Centre","place":["Monza, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario Romano","family":"Mignini Renzini","sequence":"additional","affiliation":[{"name":"Biogenesi, Reproductive Medicine Centre","place":["Monza, 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