Early prediction of ovarian multifollicular response during ovulation induction in patients with polycystic ovary syndrome.
OBJECTIVE
To examine the association between the midfollicular FSH-LH ratio and the number of follicles, and the multifollicular ovarian response to gonadotropin stimulation in patients with polycystic ovary syndrome (PCOS) with normal basal LH and FSH levels.


METHODS
Eighteen patients who had an abandoned treatment cycle because of multifollicular ovarian response. For comparison, all other completed treatment cycles in the same group of patients were used.


METHODS
The dose of hMG or FSH, daily effective dose, day 8 serum FSH and LH concentration, day 8 number of follicles > or = 8 mm, E2 and number of follicles on hCG day or day of cycle was abandoned.


RESULTS
In the abandoned cycles, day 8 serum LH concentrations were significantly lower and day 8 number of follicles and FSH-LH ratios were significantly higher compared with the completed cycles. A high predictive power (> 90%) for multifollicular response was established by using a set of two criteria: a FSH-LH ratio > or = 1.6 and the number follicles > or = 7 as the cutoff point.


CONCLUSIONS
When aiming for a monofollicular response in women with PCOS and normal basal FSH and LH levels, cycles with high midfollicular FSH-LH ratios (> or = 1.6) and a high number of follicles (> or = 7) are those prone to develop a multifollicular ovarian response.
Farhi
J
J
Department of Medicine, University College of London Medical School, Middlesex Hospital, United Kingdom.
Jacobs
H S
HS
D000328:Adult; D015415:Biomarkers; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood* / Q000627:therapeutic use; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D008596:Menotropins / Q000627:therapeutic use; D008597:Menstrual Cycle; D006080:Ovarian Follicle; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012016:Reference Values; D012189:Retrospective Studies
D015415:Biomarkers; D006063:Chorionic Gonadotropin; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone