Elevated day 3 follicle-stimulating hormone/luteinizing hormone ratio >or= 2 is associated with higher rates of cancellation in in vitro fertilization-embryo transfer cycles.
OBJECTIVE
To evaluate the day 3 FSH/LH ratio as a predictor of prognosis in IVF cycles.


METHODS
A retrospective cohort study.


METHODS
An academic hospital-based fertility center.


METHODS
Two hundred ninety-seven women younger than 40 years old with day 3 FSH levels <or=10 IU/L undergoing their first IVF cycle.


METHODS
A retrospective chart review of patients undergoing their first cycle of IVF was performed. We compared cycle characteristics and outcomes in women with normal FSH/LH ratios and those with elevated FSH/LH ratios (>or=2).


METHODS
Pregnancy and cancellation rates.


RESULTS
One-third of patients had a day 3 FSH/LH ratio >or=2.0. Patients with an elevated FSH/LH ratio were more likely to have been placed on an aggressive protocol and had higher starting (257 vs. 232 IU) and total (2484 vs. 2136 IU) FSH doses. Patients with an elevated FSH/LH ratio were more likely to have their cycles cancelled before retrieval (19.6% vs. 8.5%). Although there was a trend toward lower pregnancy rates (24.7% vs. 33.5%), this result was not statistically significant. No clinical pregnancies occurred in 16 women with an FSH/LH ratio >or=3.5.


CONCLUSIONS
An increased FSH/LH ratio of >or=2.0 was associated with poorer IVF cycle outcomes and higher rates of cycle cancellation.
Liu
Kimberly E
KE
Reproductive Biology Unit, Mount Sinai Hospital, Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
Greenblatt
Ellen M
EM
D000328:Adult; D015331:Cohort Studies; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D010053:Ovary / Q000502:physiology; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D012189:Retrospective Studies
D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone