Assessment of the role of serum luteinizing hormone and estradiol response to follicle-stimulating hormone on in vitro fertilization treatment outcome.

OBJECTIVE

To analyze the role of serum LH and of E2 secretion on IVF-ET outcome in patients stimulated with FSH.

DESIGN

Using data from three studies, we analyzed ovarian response to FSH and IVF-ET outcome from two standpoints: [1] serum LH and [2] serum E2 on the day of hCG administration divided by the number of retrieved oocytes.

SETTING

Twenty-six academic and private clinical centers.

PATIENT(S): Three hundred twenty-three ovulatory patients eligible for IVF-ET.

INTERVENTION(S): Patients were treated with a GnRH agonist and FSH and underwent IVF-ET.

MAIN OUTCOME MEASURE(S): Follicular development, embryos, and pregnancy rate (PR).

RESULT(S): Serum LH levels did not correlate significantly with number of oocytes retrieved, E2-oocyte ratio, fertilization rate, or PR. Five patient subpopulations were identified on the basis of E2-oocyte ratios: 0 to 70 (A), 70 to 140 (B), 140 to 210 (C), 210 to 280 (D), and > 280 (E) pg/mL per oocyte (conversion factor to SI unit, 3.671). Pregnancy rates were significantly different, i.e., 5.3%, 31.3%, 18.1%, 23.9%, and 20.4% for groups A, B, C, D, and E, respectively. Groups were not different in terms of baseline characteristics, number of follicles, fertilization rates, and number of embryos transferred.

CONCLUSION

Patients with very low levels of LH respond to FSH alone as well as those with higher LH. The E2-oocyte ratio is a strong index of success rate.