Elevated day 3 FSH/LH ratio: a marker to predict IVF outcome in young and older women

PURPOSE: To evaluate the value of elevated day 3 FSH/LH ratio in predicting IVF results in young and older women. METHODS: One hundred seventy-four women with normal day 3 FSH levels undergoing IVF treatment were studied. Patients were divided into two groups according to basal FSH/LH ratio: Group 1(FSH/LH ≥3, n = 43) and Group 2 (FSH/LH <3, n = 131). The effects of FSH/LH ratio on IVF outcomes were compared. Also, the impact of elevated FSH/LH levels on younger (<35 years; n = 113) and older (≥35 years; n = 61) women was evaluated. RESULTS: Group 1 had significantly lower mean day 3 LH levels (p = 0.001), lower number of oocytes retrieved (p = 0.004) and lower clinical pregnancy rate (p = 0.04). Older women with elevated FSH/LH ratio (n = 23) had significantly lower transferred good grade embryo counts (p = 0.04) and lower pregnancy rate (p = 0.03) versus older women with lower FSH/LH ratio. But in younger women treatment outcomes were similar in both subgroups. CONCLUSION: Elevated day 3 FSH/LH ratio is useful in predicting IVF outcome in older women, but does not seem to be an accurate predictor in younger women.