Elevated day 3 FSH/LH ratio due to low LH concentrations predicts reduced ovarian response

Shrim, Alon; Elizur, SE; Ds, Seidman; Rabinovici, Jaron; Wiser, Amir; Dor, J.

doi:10.1016/s1472-6483(10)61993-1

Cited by 41 publications

(35 citation statements)

References 25 publications

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“…Also, this study finds an increase in LH/FSH ratio effect on IVF outcome is similar to that by Barroso et al [7] and Shrim et al [10], which reported similar results in patients with elevated LH/FSH ratio >3. Also from this study, GnRHa (Gonapeptyl.01 ® ) has better effectiveness (114%) on total number of oocytes retrieved than other triggering medicine as well as similar effectiveness in stimulating oocytes maturation as uHCG (75% to 81%) which is in agreement with the concept by Shahar and Peter, 2013 which suggested that a 0.2 mg of gonadotrophin-releasing hormone agonist (GnRHa) can replace human chorionic gonadotrophin (HCG) as a trigger of final oocyte maturation and that GnRHa trigger offers important advantages, including significant prevention of ovarian hyperstimulation syndrome (OHSS), safety and comfort of patients.…”

Section: Discussionsupporting

confidence: 91%

Influence of Elevated LH: FSH Ratio on IVF Outcome, Comparing the Impacts of Different Triggering Medicines

Khrait¹

2017

J Fertil In Vitro IVF Worldw Reprod Med Genet Stem Cell Biol

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Objective: To study how elevated LH: FSH ratio influence IVF outcome in High response patients with different triggering medicines.Design: This study was observational study performed in Medcare Fertility Centre, Dubai, UAE, between April 2016 to July 2017.Patients: 81 high ovarian response women (AMH ≥ 4 ng/ml and LH/FSH ≥ 1). Main outcome:Measures the impact of high LH/FSH ratioo on IVF outcome in according to the triggering used.

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Section: Discussionsupporting

confidence: 91%

Influence of Elevated LH: FSH Ratio on IVF Outcome, Comparing the Impacts of Different Triggering Medicines

Khrait¹

2017

J Fertil In Vitro IVF Worldw Reprod Med Genet Stem Cell Biol

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“…diminished ovarian reserve and poor IVF outcome [7][8][9][10][11][12]. However, in the studies investigating the impact of elevated FSH/LH ratio as a predictor of prognosis in IVF success, analysis according to age was not performed.…”

Section: Introductionmentioning

confidence: 99%

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

Seckin

Türkçapar

Özakşit

2011

Fertility and Sterility

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Purpose To evaluate the value of elevated day 3 FSH/LH ratio in predicting IVF results in young and older women. Methods One hundred seventy-four women with normal day 3 FSH levels undergoing IVF treatment were studied. Patients were divided into two groups according to basal FSH/LH ratio: Group 1(FSH/LH ≥3, n043) and Group 2 (FSH/LH <3, n0131). The effects of FSH/LH ratio on IVF outcomes were compared. Also, the impact of elevated FSH/LH levels on younger (<35 years; n0113) and older (≥35 years; n061) women was evaluated. Results Group 1 had significantly lower mean day 3 LH levels (p00.001), lower number of oocytes retrieved (p00.004) and lower clinical pregnancy rate (p00.04). Older women with elevated FSH/LH ratio (n023) had significantly lower transferred good grade embryo counts (p00.04) and lower pregnancy rate (p00.03) versus older women with lower FSH/LH ratio. But in younger women treatment outcomes were similar in both subgroups. Conclusion Elevated day 3 FSH/LH ratio is useful in predicting IVF outcome in older women, but does not seem to be an accurate predictor in younger women.

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“…13,17,24 It is of note that a number of the studies have moved to reiterate the importance of generating individualized data from centres in terms of using LH as it seems likely that the available data is not universally applicable due to factors such as the heterogeneity of individual patient populations, laboratory assays which themselves show inter laboratory variation of LH quantification and stimulation protocols. 17,21,24 For the purposes of establishing LH as an ORT, these findings need to be viewed in line with the current opinion and controversies surrounding ORTs and their value. In order to give further context to these issues, we use two ovarian markers which look the most promising in becoming established as the 'ideal' markers of ovarian reserve -Antimüllerian hormone (AMH) and the antral follicle count (AFC) -as reference points.…”

Section: Discussionmentioning

confidence: 99%

“…There was still a statistically significant reduction in cycle outcomes. 17 Orvieto et al payed special attention to patients undergoing both agonist (n = 131) and GnRH antagonist (n=137) protocols , and once again both subgroups achieved lower pregnancy rates in contrast to their controls (11.1 vest 27.7 and 8.3 vs. 31.9) with FSH/LH ratios >2 or >3. It is of note that the FSH/ LH ratio still maintained its discriminative ability in this population who were selected on the premise that they had a favourable prognosis for ART (women <35 years of age with day 3 FSH <15IU/L undergoing up to their 3 rd IVF cycle).…”

Section: The Evidence For Lh As a Marker Of Ovarian Reservementioning

confidence: 99%

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A review of luteinizing hormone and its role in ovarian reserve testing

Smith

Osianlis

Vollenhoven

2014

Int J Reprod Contracept Obstet Gynecol

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Ovarian reserve tests (ORTs) have become part of the antecedent workup for individuals undergoing assisted reproductive technology (ART). In 1988, the foundations for ORTs were first laid by studies indicating a potential role for basal follicle stimulating hormone (FSH) in predicting pregnancy. 1Since then basal FSH measurement has gone on to become the most commonly used marker of ovarian reserve.2 Given the synergistic interplay of both FSH and luteinizing hormone (LH) in ovarian physiology which ARTs attempt to mimic, it is of interest that LH has not been explored in the same capacity. This review aims to illustrate the physiological role played by LH in folliculogenesis and critically review the available literature to determine if LH does indeed have a role in ovarian reserve testing. OVARIAN RESERVE TESTINGThe term ovarian reserve aims to correlate reproductive potential with the number and quality of remaining oocytes in women of reproductive age.3 Ovarian reserve testing aims to quantify this relationship by measuring either oocyte quality, quantity or the ability for an individual to achieve pregnancy. These tests can be conducted either through biochemical means or through ultrasonographic measures. ABSTRACTBackground: Ovarian physiology illustrates the synergistic interaction between luteinizing hormone and follicle stimulating hormone in the process of folliculogenesis. While follicle stimulating hormone has been well established as a marker of ovarian reserve, the role of luteinizing hormone has remained somewhat controversial and it seems to have become the 'forgotten gonadotropin'. The following review aims to investigate the available evidence surrounding luteinizing hormone as an ovarian reserve test and examine the issues which need to be addressed in order to establish it as an ovarian reserve test. It then further attempts to propose a model to direct effective research to ascertain if it does have a role to play in ovarian reserve testing. Findings: The evidence is equivocal in the use of luteinizing hormone as an independent predictor of ovarian reserve. However, there is much stronger evidence to suggest that the follicle stimulating hormone/luteinizing hormone ratio is a useful marker of ovarian reserve-in particular when it is ≥2 and approaching 3. The evidence base for this ratio at present however is sparse. In addition, ovarian reserve tests are fraught with issues over reliability, accuracy, definition and the implications of testing itself. In order to overcome these issues, more quality research needs to be carried out to test this relationship between luteinizing hormone and follicle stimulating hormone.

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Elevated day 3 FSH/LH ratio due to low LH concentrations predicts reduced ovarian response

Cited by 41 publications

References 25 publications

Influence of Elevated LH: FSH Ratio on IVF Outcome, Comparing the Impacts of Different Triggering Medicines

Influence of Elevated LH: FSH Ratio on IVF Outcome, Comparing the Impacts of Different Triggering Medicines

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

A review of luteinizing hormone and its role in ovarian reserve testing

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