The serum follicle-stimulating hormone-to-luteinizing hormone ratio at the start of stimulation with gonadotropins after pituitary down-regulation is inversely correlated with a mature oocyte yield and can predict "low responders".
OBJECTIVE
The aim of this study was to investigate the relationship of serum FSH and LH levels at the commencement of stimulation to ovarian follicular development in women undergoing pituitary down-regulation and controlled ovarian hyperstimulation with gonadotropins in IVF or intracytoplasmic sperm injection (ICSI) cycles.


METHODS
Retrospective analysis.


METHODS
An IVF program in a tertiary medical center.


METHODS
A total of 245 women proven to be pituitary down-regulated by their serum E(2) levels.


METHODS
Patients treated with a GnRH agonist and FSH and hMG underwent assisted reproductive technique (ART).


METHODS
Mature oocyte yield, pregnancy rate (PR), and live birth rate.


RESULTS
The serum FSH levels and the FSH-to-LH ratio at the commencement of gonadotropin stimulation were inversely correlated to the number of mature oocytes (r = -0.193 and r = -0.224, respectively). When assessed with receiver-operating characteristic (ROC) analysis, there was statistically significant ability for the FSH/LH ratio to differentiate between the "poor response" cycles (with mature oocyte yield < or =4) and the normal response cycles. Using the cutoff value derived from ROC analysis, cycles with the FSH-to-LH ratio > or =3 produced less mature oocytes (8.25 vs. 11.74), lower peak E(2) levels (1,975.3 pg/mL vs. 3,324.8 pg/mL), and higher percentage of poor ovarian response cycles (32.5% vs. 14.3%).


CONCLUSIONS
The serum FSH-to-LH ratio at the start of gonadotropin stimulation after pituitary down-regulation provided a practical method for early prediction of mature oocyte yield.
Ho
Jason Yen-Ping
JY
Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, 160 Chung-Kang Road Section 3, Taichung 407, Taiwan.
Guu
Hwa-Fen
HF
Yi
Yu-Chiao
YC
Chen
Ming-Jer
MJ
Ho
Esther Shih-Chu
ES
D000328:Adult; D015415:Biomarkers; D015536:Down-Regulation / Q000187:drug effects; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D005640:Follicle Stimulating Hormone / Q000097:blood*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D007986:Luteinizing Hormone / Q000097:blood*; D008596:Menotropins / Q000008:administration & dosage; D009865:Oocytes / Q000166:cytology*; D010053:Ovary / Q000166:cytology / Q000187:drug effects; D010062:Ovulation Induction; D010902:Pituitary Gland / Q000187:drug effects* / Q000378:metabolism; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D015415:Biomarkers; D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone