Polymorphism of the FSH receptor and ovarian response to FSH.

Follicle-stimulating hormone (FSH) is a key factor in human reproduction. FSH activates its receptor (FSHR) located exclusively on Sertoli cells in the testis and granulosa cells in the ovary. Two common single nucleotide polymorphisms (SNP) within exon 10 of the human FSHR gene result in two almost equally common allelic variants exhibiting threonine (Thr) or alanine (Ala) at position 307 in the hinge region, respectively, asparagine (Asn) or serine (Ser) at codon 680 of the intracellular domain. Clinical studies have demonstrated that p.N680S polymorphism determines the ovarian response to FSH stimulation in patients undergoing IVF-treatment. Patients with the Ser(680) allele need more FSH during the stimulation phase to reach the serum estradiol levels of Asn(680) patients. A study investigating women with normal, mono-ovulatory menstrual cycles revealed that the Ser(680)/Ser(680) genotype leads to higher FSH serum levels and a prolonged cycle. To date, the molecular mechanism underlying the partial "resistance" of the Ser(680)-FSHR to FSH remains unclear. Future experiments should extend our current understanding of FSH action on follicular selection and dominance, thereby permitting novel, patient-tailored therapies for infertility and fertility preservation.