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4096551 
Journal Article 
Predictive Value of Elevated LH/FSH Ratio for Ovulation Induction in Patients with Polycystic Ovary Syndrome 
Woo, I; Tobler, K; Khafagy, A; Christianson, MS; Yates, M; Garcia, J 
2015 
Yes 
Journal of Reproductive Medicine
ISSN: 0024-7758
EISSN: 1943-3565 
60 
11-12 
495-500 
English 
26775457 
OBJECTIVE: To assess the value of an elevated luteinizing hormone (LH)-to-follicle-stimulating hormone (FSH) ratio in predicting development of a dominant follicle when ovulation induction is implemented with clomiphene citrate (CC) or letrozole in women with polycystic ovary syndrome (PCOS).

STUDY DESIGN: Retrospective review of 312 monitored cycles between 2007 and 2012. All patients met the diagnostic criteria set by the 2006 Androgen Excess-PCOS Society and had baseline LH and FSH levels drawn. Only ovulation induction with CC or letrozole was included. Primary outcome was development of a dominant follicle of ≥ 18 mm.

RESULTS: The development of a dominant follicle was significantly associated with clinical pregnancy. The development of a dominant follicle was also higher in the letrozole group as compared to the CC group (87.6% [155/177] vs. 62.2% [84/135], p < 0.001). Furthermore, treatment with letrozole significantly increased the odds of forming a dominant follicle when LH/FSH ratio was ≥ 1 (odds ratio [OR] 7.69, CI 3.69-16.02). When LH/ FSH ratio was < 1, letrozole had no significant effect on dominant follicle development (OR of 3.63, CI 0.92-14.25).

CONCLUSION: LH/FSH ratio ≥ 1 could be useful as a predictive tool to identify which subgroup of PCOS patients may be more successful in forming a dominant follicle when using letrozole as compared to CC.