title: What is the best treatment for women with polycystic ovarian syndrome and high LH/FSH ratio? A comparison among in vitro fertilization with GnRH agonist, GnRH antagonist and in vitro maturation.
abstract: OBJECTIVE
  To evaluate whether high LH/FSH ratio has a clinical impact on patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF) with GnRH-agonist/antagonist protocols or in vitro maturation (IVM) treatments.
  
  
  METHODS
  We retrospectively reviewed all PCOS patients with day 3 LH/FSH ratio ≥1.5 who underwent IVF or IVM. The main outcomes measures were embryo quality and pregnancy rate.
  
  
  RESULTS
  A total of 75 cycles were included. Among these, 44 patients underwent long agonist protocol, 16 antagonist protocol and 15 IVM. Age, basal LH and FSH levels, as well as duration of infertility were comparable for all groups. The LH level on the day of hCG administration was significantly lower in the antagonist group (0.9 IU/ml) compared to the long agonist group (1.4 IU/ml, p = 0.01). There was no difference in pregnancy rates among the groups: 27.2 % in the long agonist group, 37.5 % in the antagonist group and 26.6 % among the IVM patients.
  
  
  CONCLUSIONS
  High LH/FSH ratio had no adverse effect on pregnancy rates in all three treatment modes.
authors.affiliation: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tshernichovsky Street, Kfar Saba, Israel. yael.ganor@gmail.com.|Tel Aviv University, Tel Aviv, Israel. yael.ganor@gmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Ganor-Paz
authors.affiliation: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tshernichovsky Street, Kfar Saba, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Friedler-Mashiach
authors.affiliation: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tshernichovsky Street, Kfar Saba, Israel.|Tel Aviv University, Tel Aviv, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Ghetler
authors.affiliation: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tshernichovsky Street, Kfar Saba, Israel.|Tel Aviv University, Tel Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Hershko-Klement
authors.affiliation: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tshernichovsky Street, Kfar Saba, Israel.|Tel Aviv University, Tel Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Berkovitz
authors.affiliation: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tshernichovsky Street, Kfar Saba, Israel.|Tel Aviv University, Tel Aviv, Israel.
authors.forename: O
authors.initials: O
authors.lastname: Gonen
authors.affiliation: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tshernichovsky Street, Kfar Saba, Israel.|Tel Aviv University, Tel Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Shulman
authors.affiliation: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tshernichovsky Street, Kfar Saba, Israel.|Tel Aviv University, Tel Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Wiser
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000037:antagonists & inhibitors; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D059471:In Vitro Oocyte Maturation Techniques; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control*; D007986:Luteinizing Hormone / Q000097:blood*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000031:analogs & derivatives / Q000627:therapeutic use; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D006727:Hormone Antagonists; C000601071:triptorelin lactate; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: High LH/FSH ratio; IVF; IVM; PCOS