title: Elevated day 3 FSH/LH ratio due to low LH concentrations predicts reduced ovarian response.
abstract: Adequate ovarian response, essential for successful IVF, cannot be accurately predicted. This study retrospectively reviewed all patients undergoing IVF from 1998 to 2001. Inclusion criteria were age <41 years at treatment onset and a basal day 3 serum FSH concentration <12 IU/l. Women with FSH <or=8 IU/l underwent a secondary analysis. Two groups emerged according to basal day 3 serum FSH/LH ratio: >or=3 in group 1 and <3 in group 2 (controls). Age at treatment initiation, basal serum day 3 FSH and LH concentrations, peak serum oestradiol concentration, number of retrieved and fertilized oocytes and pregnancy rate were analysed. Groups 1 (n = 41, 111 IVF treatment cycles) and 2 (n = 596, 1,434 IVF treatment cycles) were similar in term of woman's mean age. Group 1 had significantly higher mean basal day 3 FSH concentration (P < 0.01) and significantly lower oestradiol concentrations at oocyte retrieval (P < 0.01), mean number of oocytes retrieved and fertilized (P < 0.01) and pregnancy rate (P = 0.016). The same trend persisted after excluding 98 patients with basal FSH concentrations >8 IU/l. In conclusion, elevated day 3 FSH/LH ratio is associated with an inferior outcome in IVF treatment cycles and may be used as an additional predictor for decreased ovarian response.
authors.affiliation: IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Centre, Tel-Hashomer, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. alon.shrim@utoronto.ca
authors.forename: A
authors.initials: A
authors.lastname: Shrim
authors.forename: S E
authors.initials: SE
authors.lastname: Elizur
authors.forename: D S
authors.initials: DS
authors.lastname: Seidman
authors.forename: J
authors.initials: J
authors.lastname: Rabinovici
authors.forename: A
authors.initials: A
authors.lastname: Wiser
authors.forename: J
authors.initials: J
authors.lastname: Dor
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000628:therapy*; D007986:Luteinizing Hormone / Q000097:blood*; D010062:Ovulation Induction / Q000379:methods*; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone