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Hum. Reprod. Advance Access originally published online on July 17, 2009
Human Reproduction 2009 24(11):2755-2759; doi:10.1093/humrep/dep254
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

High basal LH levels in combination with low basal FSH levels are associated with high success rates at assisted reproduction

Thomas Brodin1,2,3,5, Torbjörn Bergh1,3, Lars Berglund4, Nermin Hadziosmanovic4 and Jan Holte1,3

1 Carl von Linné Clinic, Uppsala Science Park, S-751 83 Uppsala, Sweden 2 Department of Obstetrics and Gynaecology, Mälarsjukhuset, S-631 88 Eskilstuna, Sweden 3 Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, S-751 85 Uppsala, Sweden 4 Uppsala Clinical Research Center, Akademiska sjukhuset, UCR, S-751 85 Uppsala, Sweden

5 Correspondence address. thomasbrodin{at}telia.com

BACKGROUND: The objective of this study was to evaluate the associations of basal gonadotrophins with pregnancy and delivery rates at IVF/ICSI.

METHODS: A prospective observational study was conducted at a university-affiliated private infertility centre. Patients were 745 women, who underwent 1328 IVF/ICSI treatment cycles. Basal FSH, basal LH and combinations of FSH and LH versus treatment data and pregnancy and delivery rates were measured.

RESULTS: Combinations of FSH and LH gave significantly better information than the LH:FSH ratio, or each gonadotrophin alone: highest mean pregnancy rate (39%) was achieved in women with low FSH (<6.7 U/l) and with high LH levels (>4.9 U/l), whereas pregnancy rate was lowest (22%) in women with high FSH and low LH levels. Pregnancy rates were intermediate (27–28%) if FSH and LH were either both low or both high (P for trend = 0.0004). Associations to delivery rates and measures of ovarian response and embryo quality followed the same pattern.

CONCLUSIONS: Basal LH modifies and improves the information given by basal FSH alone. Low FSH level combined with high LH probably reflects a well-preserved ovarian reserve and is associated with the highest success rates at IVF/ICSI.

Key words: FSH/infertility/IVF/ICSI outcome/luteinizing hormone/ovarian reserve

Submitted on February 8, 2009; resubmitted on April 23, 2009; accepted on June 17, 2009.


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