The effect of baseline serum luteinizing hormone levels on follicular development, ovulation, conception and pregnancy outcome in infertile patients with polycystic ovarian syndrome

Background: Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder in infertile women. Raised tonic levels of luteinizing hormone (LH) is one of the main endocrinological disturbances in PCOS patients. Objective of present study was to evaluate the effect of baseline serum luteinizing hormone levels on follicular development, ovulation and conception and pregnancy outcome in infertile patients with PCOS.Methods: This is a prospective study conducted on 50 consecutive infertile patients with PCOS. Baseline Day 2 serum luteinizing hormone concentration was done in selected patients. Ovulation induction was done with clomiphene citrate 100 mg from Day 3 to Day 7 of the cycle. Then patients were monitored for follicular development, ovulation, conception and early pregnancy loss.Results: The mean age of the patients is 25±3.6 yrs. The average duration of infertility is 5.4 yrs (2-10). The mean basal serum LH concentration in patients who ovulated was significantly low (5.6 IU) in comparison with patients who did not ovulate (10.1 IU). The mean basal serum LH concentration in patients who conceived was 3.9 IU in comparison with patients who did not conceive (5.9 IU) which was statistically significant (p=0.04). Out of 15 patients who conceived, 3 patients (20%) had early pregnancy loss.Conclusions: Tonic hyper secretion of LH results in premature oocyte maturation, causing the problems with fertilization and miscarriage. Inappropriately raised LH appears to have deleterious effects on the pregnancy outcome