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

ABSTRACT

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.