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

Journal of Endocrinological Investigation
Y Ganor-PazAmir Wiser

Abstract

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. 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. 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. High LH/FSH ratio had no adverse effect on pregnancy rates in all three treatment modes.

References

Jul 1, 1997·The Journal of Clinical Endocrinology and Metabolism·A E TaylorJ E Hall
Apr 2, 2002·Human Reproduction·Carmen MendozaJan Tesarik
Oct 18, 2002·Obstetrics and Gynecology·Tim J ChildSeang Lin Tan
Mar 29, 2006·Human Reproduction Update·B C TarlatzisP Devroey
Feb 5, 2008·Fertility and Sterility·UNKNOWN Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group
May 13, 2011·The Cochrane Database of Systematic Reviews·Hesham G Al-InanyAhmed M Abou-Setta
May 15, 2012·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Raoul OrvietoRavit Nahum

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Citations

Nov 18, 2003·Reproductive Biology and Endocrinology : RB&E·Roy Homburg
Aug 30, 2018·International Journal of Endocrinology·Shital JulaniaRoger Hart

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