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What is the best treatment for women with polycystic ovarian syndrome and high LH/FSH ratio? A comparison among in vitro fertilization with GnRH agonist, GnRH antagonist and in vitro maturation

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Abstract

Purpose

To evaluate whether high LH/FSH ratio has a clinical impact on patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF) with GnRH-agonist/antagonist protocols or in vitro maturation (IVM) treatments.

Methods

We retrospectively reviewed all PCOS patients with day 3 LH/FSH ratio ≥1.5 who underwent IVF or IVM. The main outcomes measures were embryo quality and pregnancy rate.

Results

A total of 75 cycles were included. Among these, 44 patients underwent long agonist protocol, 16 antagonist protocol and 15 IVM. Age, basal LH and FSH levels, as well as duration of infertility were comparable for all groups. The LH level on the day of hCG administration was significantly lower in the antagonist group (0.9 IU/ml) compared to the long agonist group (1.4 IU/ml, p = 0.01). There was no difference in pregnancy rates among the groups: 27.2 % in the long agonist group, 37.5 % in the antagonist group and 26.6 % among the IVM patients.

Conclusions

High LH/FSH ratio had no adverse effect on pregnancy rates in all three treatment modes.

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Correspondence to Y. Ganor-Paz.

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This research did not receive financial support.

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The authors declare no conflicts of interest.

Ethical approval

The study was approved by the local Institutional Review Committee.

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Due to the retrospective nature of the study, informed consent was waived.

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Ganor-Paz, Y., Friedler-Mashiach, Y., Ghetler, Y. et al. What is the best treatment for women with polycystic ovarian syndrome and high LH/FSH ratio? A comparison among in vitro fertilization with GnRH agonist, GnRH antagonist and in vitro maturation. J Endocrinol Invest 39, 799–803 (2016). https://doi.org/10.1007/s40618-015-0429-x

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  • DOI: https://doi.org/10.1007/s40618-015-0429-x

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