Effect of Basal Gonadotropins, Prolactin and Anthropometry as Predictive Markers of Ovarian Response in Patients Seeking Assisted Reproduction

Abstract

Assisted reproduction is expensive, time-consuming and stressful for patients. The accurate determination of ovarian reserve is important for this procedure. Basal hormonal levels may help to predict ovarian reserve after stimulation. The aim of this study was to assess basal hormonal markers; Luteinizing Hormones (LH), Follicle stimulating (FSH), prolactin and anthropometric indices as predictive markers of ovarian response in patients seeking assisted reproduction. A total of 104 subjects were recruited at the Lister Hospital Fertility Centre in Accra-Ghana for this study. Anthropometric parameters: Body Mass Index (BMI) and Waist-to-Hip Ratio (WHR) were measured. Lifestyle features; exercise and smoking patterns were assessed from a questionnaire. Blood samples were drawn on second day of their menstrual cycle in the month prior to the in vitro fertilization (IVF) procedure and basal luteinizing hormones, FSH and prolactin assayed by ELISA method. Subjects who yielded four or less oocytes were classified as poor responders whereas those who yielded more than 4 oocytes were termed as normal responders. Basal FSH and age (12.9±0.51 IU LG and 40±0.54 years) were significantly (p<0.01) higher in poor responders than normal responders 9.7±0.61 IU LG and 36±0.42 years, respectively. Increasing age, (42.44±0.47 years), high basal FSH (13.41±0.91 IU LG) and high FSH/LH ratio (2.74±0.64) significantly but negatively correlated with retrieved oocyte (7.28±2.03) and ovarian capacity (8.44±1.16) when compared to low age (28.08±0.65 years), normal FSH (7.64±1.21 IU LG) and FSH/LH (1.23±0.16) with retrieved oocyte (20.31±3.30) and ovarian capacity (20.92±2.63), respectively. Subjects engaged in moderate to high forms of exercise recorded a normal response. Number of retrieved oocytes and ovarian capacity were negatively correlated to WHR and BMI. Basal FSH and FSH/LH ratio better predicted response of subjects after ovarian stimulation. Obesity negatively impacted on ovarian response.