Elevated day 3 FSH/LH ratio: a marker to predict IVF outcome in young and older women

Seckin, Berna; Türkçapar, Figen; Özakşit, Gülnur

doi:10.1007/s10815-011-9695-5

Cited by 22 publications

(13 citation statements)

References 23 publications

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“…It has previously been shown that FSH:LH ratio can be used as predictor of pregnancy outcome in infertile women [35], but this was not confirmed in the present study. It has also been demonstrated that AMH is a better marker than age, FSH on cycle day 3 or inhibin B for prediction of IVF pregnancy success [36], which could neither be shown in the present study.…”

Section: Discussioncontrasting

confidence: 93%

Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility

Murto

Bjuresten

Landgren

et al. 2013

Reprod Biol Endocrinol

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BackgroundInfertile women might get pregnant sometime after fertility treatment, but today, there is no prediction model on who will eventually have children. The objective of the present study was to characterize hormone levels in an arbitrary menstrual cycle in women with unexplained infertility and male infertility, and to determine the predictive value for long-term possibility of live birth.MethodsIn this cross-sectional study, with 71 infertile women with diagnosis unexplained infertility and male infertility, blood samples were obtained during the proliferative and secretory phases of an arbitrary menstrual cycle. Serum concentrations of FSH, LH, AMH, inhibin B, estradiol, progesterone, PRL and TSH were determined. The predictive value of ovulation and hormonal analysis was determined by identifying the proportion of women with at least one live birth. Mann Whitney U test, chi2 test and Spearman’s correlation were used for statistical analysis. A value of p < 0.05 was considered statistically significant.ResultsThere were no differences in hormone values and live birth rates between women with unexplained infertility and male infertility. The best sole predictors of live birth were age of the women, followed by ovulatory cycle, defined as serum progesterone concentration of greater than or equal to 32 nmol/L, and a serum TSH concentration of less than or equal to 2.5 mIU/L. Combining the age with the ovulatory cycle and serum TSH less than or equal to 2.5 mIU/L or serum AMH greater than or equal to 10 pmol/L the predictive value was close to 90%.ConclusionsAge in combination with the presence of an ovulatory cycle and serum TSH or serum AMH is predictive for long-term live birth. The advantage of serum AMH compared with serum TSH is the very little variation throughout the menstrual cycle, which makes it a useful tool in infertility diagnosis.

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Section: Discussioncontrasting

confidence: 93%

Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility

Murto

Bjuresten

Landgren

et al. 2013

Reprod Biol Endocrinol

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“…Our results also showed a significant reduction in the number of embryos in group A who showed lower LH: FSH ratio, Seckin et al finding was near to our results, but he classified the patients according to their age as he found that women ≥35 years old with elevated FSH/LH ratio had significantly lower number of retrieved oocytes, lower transferred good grade embryos count, and lower pregnancy rate versus women at the same age but with lower FSH/LH ratio. [38]. Liu et al, and Rehman et al found an inverse relationship between FSH-LH ratio and the number of day 3 embryos, and number of blastocysts, while in our study the count of blastocysts were lower in patients with lower LH: FSH ratio but not significant [24,31].…”

Section: Discussion:-contrasting

confidence: 46%

Early Follicular Phase LH concentration and LH to FSH ratio as Predictor of IVF/ICSI Outcome.

Al-Anbari.¹

2016

IJAR

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Background: This study was undertaken to evaluate the effect of early follicular phase LH level and LH: FSH ratio on number of mature follicles, retrieved oocytes, oocytes maturity, quality of embryo, and pregnancy rate. Methods: This retrospective observational study was undertaken in the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies /Al-Nahrain University. The study included 115 women who underwent IVF/ICSI treatment cycles from February 2015 to may 2016. Prior to the first IVF/ICSI treatment all women included in the study had blood samples analyzed on menstrual cycle Day 2, 3 or 4 for basal levels of Follicle stimulating hormone and Luteinizing hormone. Patients was sub grouped according to early follicular phase LH to FSH ratio into group A ≤0.5 and group B>0.5, and regarding early follicular phase LH into Group I (≤3 mIU/ml) and Group II (>3 mIU/ml) Results: Women with elevated early follicular phase LH to FSH ratio (LH: FSH>0.5) required significantly (p<0.001) lower doses of gonadotrophins. The outcome of IVF/ICSI was significantly (p<0.001) better in those patients they had larger number of mature follicles (≥17mm), retrieved oocytes, mature oocytes (metaphase II), fertilized oocytes, cleaved embryos, and pregnancy rates. On the other hand, patients with early follicular phase LH >3 mIU/ml did not differ significantly than patients with early follicular phase (≤3 mIU/ml). Conclusion: Elevated early follicular phase LH/FSH ratio rather than LH concentration alone is associated with the highest success rates in IVF/ICSI, perhaps reflecting a well-preserved ovarian reserve.

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“…FSH and LH levels are commonly used for the prediction of the ovarian reserve in the early follicular phase even though they have a lower predictive value. Recently, there was a report that elevated day 3 FSH/LH ratio ≥2 is associated with higher rates of cancellation in In Vitro Fertilization (IVF)-embryo transfer cycles ( 14 ) and some studies have shown that the day 3 FSH to LH or LH to FSH ratio can be used as a predictor of the ovarian reserve ( 14 , 15 , 16 , 17 , 18 , 19 ). The day 3 LH/FSH ratio is relatively easy to obtain and shows more predictive power as the day 3 FSH level alone.…”

Section: Discussionmentioning

confidence: 99%

“…They showed that patients with polycystic ovaries have statistically significant higher LH levels and LH/FSH ratios than patients with normal ovaries ( 13 ). And some studies suggested that the LH/FSH ratio could be used as a marker of fertility or ovarian reserve ( 14 , 15 , 16 , 17 , 18 , 19 ). However, only serum FSH and AMH levels have been still focused and regarded as useful markers to predict the ovarian reserve in women of reproductive age.…”

Section: Introductionmentioning

confidence: 99%

Correlation between the Serum Luteinizing Hormone to Folliclestimulating Hormone Ratio and the Anti-Müllerian Hormone Levels in Normo-ovulatory Women

et al. 2015

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Serum anti-Müllerian hormone (AMH) levels are regarded as an age-specific marker for predicting the ovarian reserve in women of reproductive age. Some studies have shown that the luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio can be used as a predictor of ovarian reserve. The purpose of this study was to assess the variation of LH/FSH ratio with aging and to evaluate the correlation between serum LH/FSH ratio and AMH levels as a predictor of the ovarian reserve in normo-ovulatory women. We retrospectively analyzed the day 3 serum hormone levels in 1,251 patients (age range: 20-50 yr) between January 2010 and January 2011. We divided the patients into 6 groups according to their age. Relation between serum AMH level and LH/FSH ratio was analyzed statistically. The serum AMH level was inversely correlated with age (r = -0.400, P < 0.001). A significant negative correlation was found between serum LH/FSH ratio and age (r = -0.213, P < 0.001). There was a significant partial correlation between serum LH/FSH ratio and AMH level when adjusted by age (r = 0.348, P < 0.001). The LH/FSH ratio could be considered as a useful marker for the ovarian reserve and could be applied to the clinical evaluation with AMH.

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Elevated day 3 FSH/LH ratio: a marker to predict IVF outcome in young and older women

Cited by 22 publications

References 23 publications

Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility

Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility

Early Follicular Phase LH concentration and LH to FSH ratio as Predictor of IVF/ICSI Outcome.

Correlation between the Serum Luteinizing Hormone to Folliclestimulating Hormone Ratio and the Anti-Müllerian Hormone Levels in Normo-ovulatory Women

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