Long GnRH-agonist protocol in an IVF program. Is it appropriate for women with normal FSH levels and high FSH/LH ratios?
Yang, J.H.; Wu, M.Y.; Chao, K.H.; Chen, S.U.; Ho, H.N.; Yang, Y.S.
Journal of Reproductive Medicine 42(10): 663-668
1997
ISSN/ISBN: 0024-7758 PMID: 9350023 Document Number: 478431
OBJECTIVE: To determine whether subjects with an elevated ratio of follicle-stimulating hormone (FSH) to luteinizing hormone (LH) but normal basal FSH levels should be regarded as poor responders to controlled ovarian hyperstimulation. STUDY DESIGN: One hundred twenty-five women undergoing in vitro fertilization (IVF) for the first time were recruited in this retrospective cohort study. Women over 40 years old or having serum basal FSH gt 10 mIU/mL were excluded. RESULTS: Various cutoff values for the FSH/LH ratio were chosen, and the ratio demonstrated that pregnancy rates were apparently higher in patients with the long protocol than with the short one if they had an FSH/LH ratio lt 3.0 (48.5% vs. 25.8%, P = .034), lt 2.5 (53.3% vs. 28.6%, P = .030) or lt 2.0 (57.8% vs. 21.7%, P = .005). Pregnancy rates were similar with the long and short protocols in patients with FSH/LH gtoreq 3.0 (57.1% vs. 70%, P = .521), FSH/LH gtoreq 2.5 (40% vs. 53.8%, P = .435) or FSH/LH gtoreq 2.0 (40% vs. 55.6%, P = .281). CONCLUSION: This study failed to demonstrate that FHS/LH was a useful parameter for predicting reproductive outcome in IVF programs and for patient selection for the long or short gonadotropin-releasing hormone agonist protocol.