May 28th, 2018

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Effect of High LH/FSH Ratio on Women with Polycystic Ovary Syndrome Undergoing in Vitro Maturation Treatment
Authors:  Amir Wiser, M.D., Fady Shehata, M.B.B.Ch., M.Sc., Hananel Holzer, M.D., Jordana H. Hyman, Einat Shalom-Paz, M.D., Weon-Young Son, Ph.D., and Togas Tulandi, M.D., M.H.C.M.
  OBJECTIVE: To determine whether high luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratios have a clinical impact on women with polycystic ovary syndrome (PCOS) undergoing in vitro maturation (IVM) treatment.

STUDY DESIGN: Women with PCOS who underwent IVM treatment were divided into those with LH/FSH ratio >1.5 and LH/FSH 0.5 1.5. We analyzed baseline characteristics of the patients, number of oocytes retrieved, number of mature oocytes, and pregnancy rates.

RESULTS: Women with LH/FSH ratio of >1.5 had higher basal serum testosterone (2.2 vs. 1.4, p<0.005, CI 0.11.0) and estradiol (188.716.2 vs. 143.76.9, p< 0.01, CI 2396). The antral follicle count (AFC) was also higher in the patients with high LH/FSH (46.23.5 vs. 32.91.3, p<0.001, CI 721). The total number of retrieved oocytes and number of mature oocytes was also significantly higher in women with LH/FSH ratio of >1.5 than in those with a lower ratio. However, the pregnancy rate in women with LH/FSH ratio of >1.5 (16.7%) was significantly lower than in those with a ratio of 0.5 1.5 (40.4%), p<0.05, odds ratio 0.32.

CONCLUSION: PCOS patients with LH/FSH ratio of >1.5 had higher basal testosterone, E2, and AFC but decreased pregnancy rate. This could be due to the deleterious effect of LH on folliculogenesis and endometrial receptivity.
Keywords:  follicle-stimulating hormone, in vitro maturation of oocytes, luteinizing hormone, ovulation induction, polycystic ovary syndrome
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