Assessment of the role of serum luteinizing hormone and estradiol response to follicle-stimulating hormone on in vitro fertilization treatment outcome.
OBJECTIVE
To analyze the role of serum LH and of E2 secretion on IVF-ET outcome in patients stimulated with FSH.


METHODS
Using data from three studies, we analyzed ovarian response to FSH and IVF-ET outcome from two standpoints: [1] serum LH and [2] serum E2 on the day of hCG administration divided by the number of retrieved oocytes.


METHODS
Twenty-six academic and private clinical centers.


METHODS
Three hundred twenty-three ovulatory patients eligible for IVF-ET.


METHODS
Patients were treated with a GnRH agonist and FSH and underwent IVF-ET.


METHODS
Follicular development, embryos, and pregnancy rate (PR).


RESULTS
Serum LH levels did not correlate significantly with number of oocytes retrieved, E2-oocyte ratio, fertilization rate, or PR. Five patient subpopulations were identified on the basis of E2-oocyte ratios: 0 to 70 (A), 70 to 140 (B), 140 to 210 (C), 210 to 280 (D), and > 280 (E) pg/mL per oocyte (conversion factor to SI unit, 3.671). Pregnancy rates were significantly different, i.e., 5.3%, 31.3%, 18.1%, 23.9%, and 20.4% for groups A, B, C, D, and E, respectively. Groups were not different in terms of baseline characteristics, number of follicles, fertilization rates, and number of embryos transferred.


CONCLUSIONS
Patients with very low levels of LH respond to FSH alone as well as those with higher LH. The E2-oocyte ratio is a strong index of success rate.
Loumaye
E
E
Corporate Medical Affairs, Geneva, Ares Serono, Switzerland.
Engrand
P
P
Howles
C M
CM
O'Dea
L
L
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D009865:Oocytes; D011247:Pregnancy; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone