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標題: The serum follicle-stimulating hormone-to-luteinizing hormone ratio at the start of stimulation with gonadotropins after pituitary down-regulation is inversely correlated with a mature oocyte yield and can predict "low responders"
作者: Yen-Ping, J.
Guu, H.F.
Yi, Y.C.
Chen, M.J.
Ho, E.S.C.
關鍵字: down-regulation
FSH-to-LH ratio
oocyte yield
poor ovarian
in-vitro fertilization
controlled ovarian hyperstimulation
期刊/報告no:: Fertility and Sterility, Volume 83, Issue 4, Page(s) 883-888.
摘要: Objective: The aim of this study was to investigate the relationship of serum FSH and LH levels at the commencement of stimulation to ovarian follicular development in women undergoing pituitary down-regulation and controlled ovarian hyperstimulation with gonadotropins in IVF or intracytoplasmic sperm injection (ICSI) cycles. Design: Retrospective analysis. Setting: An lVF program in a tertiary medical center. Patient(s): A total of 245 women proven to be pituitary down-regulated by their serum E-2 levels. Intervention(s): Patients treated with a GnRH agonist and FSH and hMG underwent assisted reproductive technique (ART). Main Outcome Measure(s): Mature oocyte yield, pregnancy rate (PR), and live birth rate. Result(s): The serum FSH levels and the FSH-to-LH ratio at the commencement of gonadotropin stimulation were inversely correlated to the number of mature oocytes (r = -0.193 and r = -0.224, respectively). When assessed with receiver-operating characteristic (ROC) analysis, there was statistically significant ability for the FSH/LH ratio to differentiate between the '' poor response '' cycles (with mature oocyte yield <= 4) and the normal response cycles. Using the cutoff value derived from ROC analysis, cycles with the FSH-to-LH ratio >= 3 produced less mature oocytes (8.25 vs. 11.74), lower peak E-2 levels (1,9753 pg/mL vs. 3,324.8 pg/mL), and higher percentage of poor ovarian response cycles (32.5% vs. 14.3%). Conclusion(s): The serum FSH-to-LH ratio at the start of gonadotropin stimulation after pituitary down-regulation provided a practical method for early prediction of mature oocyte yield.
ISSN: 0015-0282
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