Gonadotropin levels influence fertility success

Original Article

by David Douglas

NEW YORK (Reuters Health) - Assisted reproduction is more likely to be successful in women with high basal levels of luteinizing hormone (LH) in combination with low basal levels of follicle-stimulating hormone (FSH), Swedish researchers report in the November issue of Human Reproduction.

"We have found these results helpful in...counseling couples prior to treatment," lead investigator Dr. Thomas Brodin of Uppsala University told Reuters Health.

In their paper, he and his colleagues describe their prospective observational study of 748 women who underwent a total of 1328 in vitro fertilization and intracytoplasmic sperm injection cycles.

The highest mean pregnancy rate (39%) was achieved by women with LH levels of more than 4.9 U/L and FSH levels below 6.7 U/L. The pregnancy rate was lowest (22%) in women with low LH and high FSH levels. More evenly matched combinations gave intermediate results.

Overall, according to the investigators, the combination of FSH and LH gave significantly better information than the LH:FSH ratio, or either alone.

Dr. Brodin continued, "As LH improves the information on ovarian reserve given by basal FSH levels, commonly analyzed alone, I'd like to emphasize that an analysis of LH should be included if basal FSH is taken."

These data should not "be evaluated as a ratio with a given cut-off level, but as absolute values in relation to one another -- the way our results suggest," he concluded.

Human Reprod 2009;24:2755-2759.