Early Follicular Phase LH concentration and LH to FSH ratio as Predictor of IVF/ICSI Outcome.

Abstract

Background: This study was undertaken to evaluate the effect of early follicular phase LH level and LH: FSH ratio on number of mature follicles, retrieved oocytes, oocytes maturity, quality of embryo, and pregnancy rate. Methods: This retrospective observational study was undertaken in the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies /Al-Nahrain University. The study included 115 women who underwent IVF/ICSI treatment cycles from February 2015 to may 2016. Prior to the first IVF/ICSI treatment all women included in the study had blood samples analyzed on menstrual cycle Day 2, 3 or 4 for basal levels of Follicle stimulating hormone and Luteinizing hormone. Patients was sub grouped according to early follicular phase LH to FSH ratio into group A ≤0.5 and group B>0.5, and regarding early follicular phase LH into Group I (≤3 mIU/ml) and Group II (>3 mIU/ml) Results: Women with elevated early follicular phase LH to FSH ratio (LH: FSH>0.5) required significantly (p<0.001) lower doses of gonadotrophins. The outcome of IVF/ICSI was significantly (p<0.001) better in those patients they had larger number of mature follicles (≥17mm), retrieved oocytes, mature oocytes (metaphase II), fertilized oocytes, cleaved embryos, and pregnancy rates. On the other hand, patients with early follicular phase LH >3 mIU/ml did not differ significantly than patients with early follicular phase (≤3 mIU/ml). Conclusion: Elevated early follicular phase LH/FSH ratio rather than LH concentration alone is associated with the highest success rates in IVF/ICSI, perhaps reflecting a well-preserved ovarian reserve.