An elevated day three follicle-stimulating hormone luteinizing hormone ratio (FSH:LH) in the presence of a normal day 3 FSH predicts a poor response to controlled ovarian hyperstimulation

被引:80
作者
Mukherjee, T
Copperman, AB
Lapinski, R
Sandler, B
Bustillo, M
Grunfeld, L
机构
[1] Div. of Reproductive Endocrinology, Department of Obstetrics/Gynecology, Mount Sinai Medical Center, New York, NY 10027, One Gustave L. Levy Place
关键词
LH; FSH; LH ratio; controlled ovarian hyperstimulation; IVF;
D O I
10.1016/S0015-0282(16)58159-X
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To determine if an elevated FSH:LH ratio predicts response in infertile patients undergoing controlled ovarian hyperstimulation (COH) for IVF-ET. Design: Retrospective study. Setting: The Division of Reproductive Endocrinology at the Mount Sinai Medical Center, New York, New York. Participants: Seventy-four patients undergoing IVF-ET using similar protocols for COH with day 3 FSH, LH, and E(2) testing available for analysis. All patients were <41 years of age and had day 3 serum FSH <15 mIU/mL (conversion to SI unit, 1.00). Main Outcome Measures: Follicle-stimulating hormone:LH ratio, day 8 serum E(2), peak serum E(2), cancellation rate, pregnancy rate, and number and size of follicles. Results: An FSH:LH ratio greater than or equal to 3.6 (group I) predicted a poor response to COH (sensitivity 85.7% and specificity 95%). There were no significant differences regarding day 3 serum FSH and ampules of gonadotropins used for COH. Group I (ratio greater than or equal to 3.6) patients responded to COH with lower day 8 E(2) (97 +/- 18 versus 319 +/- 36 pg/mL; conversion factor to SI unit, 3.671), peak E(2) (422 +/- 115 versus 2,368 +/- 183 pg/mL), and fewer follicles >15 mm (1.3 +/- 0.5 versus 17.1 +/- 1.0). In group I the cycle cancellation rate (12/14) was significantly higher than the group II cycle cancellation rate (2/60) and pregnancy rate in group II (ratio <3.6) was 25%. Conclusions: The FSH:LH ratio may increase before a dramatic increase in serum FSH is observed and appears to be a useful marker of ovarian reserve.
引用
收藏
页码:588 / 593
页数:6
相关论文
共 18 条
[1]   CHARACTERIZATION OF THE PHYSIOLOGICAL PATTERN OF EPISODIC GONADOTROPIN-SECRETION THROUGHOUT THE HUMAN MENSTRUAL-CYCLE [J].
FILICORI, M ;
SANTORO, N ;
MERRIAM, GR ;
CROWLEY, WF .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1986, 62 (06) :1136-1144
[2]   EVALUATION OF THE REPRODUCTIVE-PERFORMANCE OF WOMEN WITH ELEVATED DAY-10 PROGESTERONE LEVELS DURING OVARIAN RESERVE SCREENING [J].
HOFMANN, GE ;
SCOTT, RT ;
HOROWITZ, GM ;
THIE, J ;
NAVOT, D .
FERTILITY AND STERILITY, 1995, 63 (05) :979-983
[3]   EFFECTS OF HYPOTHALAMIC AND PREOPTIC ELECTROCHEMICAL STIMULATION ON GONADOTROPIN AND PROLACTIN RELEASE IN PROESTROUS RATS [J].
KALRA, SP ;
AJIKA, K ;
KRULICH, L ;
FAWCETT, CP ;
QUIJADA, M ;
MCCANN, SM .
ENDOCRINOLOGY, 1971, 88 (05) :1150-&
[4]  
LAUFER N, 1986, REPROD FAILURE, P219
[5]  
Laufer N, 1990, INFERTILITY COMPREHE, P481
[6]   PROGRESSIVE CHANGES IN LH AND FSH AND LH - FSH RATIO IN WOMEN THROUGHOUT REPRODUCTIVE LIFE [J].
LENTON, EA ;
SEXTON, L ;
LEE, S ;
COOKE, ID .
MATURITAS, 1988, 10 (01) :35-43
[7]   AGE-RELATED-CHANGES IN FOLLICLE-STIMULATING-HORMONE, LUTEINIZING-HORMONE, ESTRADIOL AND IMMUNOREACTIVE INHIBIN IN WOMEN OF REPRODUCTIVE AGE [J].
MACNAUGHTON, J ;
BANAH, M ;
MCCLOUD, P ;
HEE, J ;
BURGER, H .
CLINICAL ENDOCRINOLOGY, 1992, 36 (04) :339-345
[8]  
MCCANN SM, 1993, ANN NY ACAD SCI, V687, P55
[9]   STATISTICAL APPROACHES TO THE ANALYSIS OF RECEIVER OPERATING CHARACTERISTIC (ROC) CURVES [J].
MCNEIL, BJ ;
HANLEY, JA .
MEDICAL DECISION MAKING, 1984, 4 (02) :137-150
[10]   AGE-RELATED-CHANGES IN THE FEMALE HORMONAL ENVIRONMENT DURING REPRODUCTIVE LIFE [J].
MUSEY, VC ;
COLLINS, DC ;
MUSEY, PI ;
MARTINOSALTZMAN, D ;
PREEDY, JRK .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1987, 157 (02) :312-317