Effect of High LH/FSH Ratio on Women with Polycystic Ovary Syndrome Undergoing in Vitro Maturation Treatment

Objective: To determine whether high luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratios have a clinical impact on women with polycystic ovary syndrome (PCOS) undergoing in vitro maturation (IVM) treatment.

Study Design: Women with PCOS who underwent IVM treatment were divided into those with LH/FSH ratio > 1.5 and LH/FSH 0.5-1.5. We analyzed baseline characteristics of the patients, number of oocytes retrieved, number of mature oocytes, and pregnancy rates.

Results: Women with LH/FSH ratio of > 1.5 had higher basal serum testosterone (2.2 vs. 1.4, p < 0.005, CI 0.1-1.0) and estradiol (188.7 +/- 16.2 vs. 143.7 +/- 6.9, p < 0.01, CI 23-96). The antral follicle count (AFC) was also higher in the patients with high LH/FSH (46.2 +/- 3.5 vs. 32.9 +/- 1.3, p < 0.001, CI 7-21). The total number of retrieved oocytes and number of mature oocytes was also significantly higher in women with LH/FSH ratio of > 1.5 than in those with a lower ratio. However, the pregnancy rate in women with LH/FSH ratio of > 1.5 (16.7%) was significantly lower than in those with a ratio of 0.5-1.5 (40.4%), p < 0.05, odds ratio 0.32.

Conclusion: PCOS patients with LH/FSH ratio of > 1.5 had higher basal testosterone, E2, and AFC but decreased pregnancy rate. This could be due to the deleterious effect of LH on folliculogenesis and endometrial receptivity.