Variant-beta luteinizing hormone is not associated with poor ovarian response to controlled ovarian hyperstimulation
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Variant-beta luteinizing hormone is not associated with poor ovarian response to controlled ovarian hyperstimulation Hans I Hanevik1*, Hilde T Hilmarsen2, Camilla F Skjelbred2, Tom Tanbo3 and Jarl A Kahn1
Abstract Background: The most common genetic variant of luteinizing hormone (LH), variant-betaLH, has a different bioactivity than the wildtype. Carrying the variant allele was associated with an increased consumption of exogenous gonadotropin to achieve optimal ovarian response for in vitro fertilization procedures (IVF). The aim of this study was to examine if variant-betaLH was also more common in patients with a poor ovarian response to exogenous gonadotropin which negatively influenced treatment outcome. Findings: 36 patients with poor ovarian response to ovarian stimulation for IVF and 98 controls with a normal response were genotyped for variant-betaLH using DNA sequencing. The carrier frequency in the control group was 17%. No association was found between poor ovarian response and variant-betaLH. Conclusions: Testing patients for variant-betaLH prior to IVF is unlikely to predict poor ovarian response. Keywords: Luteinizing hormone, Genetic variant, Variant-beta LH, Ovarian response, IVF
Findings Background
The most common form of genetically determined variation in luteinizing hormone (LH) structure is variantbetaLH (v-betaLH) [1]. v-betaLH is caused by a doublet of single nucleotide polymorphisms (SNPs) in the LHB gene that induces a substitution of amino acids (LHB Trp8Arg and LHB Ile15Thr) in the beta subunit of LH [2]. The LHB 15Thr introduces an additional glycosylation site to v-betaLH, probably affecting the serum half-life of LH and thereby its bioactivity [3-5]. Various physiological and clinical implications of v-betaLH were proposed, including infertility and premature ovarian failure [6,7]. In the field of in vitro fertilization (IVF), patients who required an increased amount of recombinant follicular stimulating hormone (rFSH) to achieve an optimal ovarian response in controlled ovarian hyperstimulation (COH) were classified as hypo-responders [8]. Alviggi and co-workers reported that v-betaLH was more common in hypo-responders in a series of 60 Italian IVF patients [9]. This finding was * Correspondence: [email protected] 1 Fertilitetsklinikken Sør, Telemark Hospital, Porsgrunn, Norway Full list of author information is available at the end of the article
recently confirmed in a larger series of Danish IVF patients [8], and is of interest when searching for genetic predictors of ovarian response to COH [10]. Poor ovarian response (POR) has similarities to hypo-response, but is more adverse for the patient’s treatment outcome [11]. Patients with POR have a markedly decreased chance of pregnancy from IVF treatment [12], whereas hypo-responders by definition achieve an optimal ovarian response [8]. The aim of the present study was to investigate if v-betaLH was more common in IVF patients with POR. If so, this would strengthen the case raised by A
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