Significance of FSH receptor gene polymorphism test in assisted reproduction

1. What is FSH hormone?

FSH (Folicle Stimulating Hormone) is a hormone released from the anterior pituitary gland in the brain. FSH stimulates the development of immature oocytes.
At the beginning of development, the oocyte releases estradiol, which in turn acts on the hypothalamus and pituitary gland to increase the release of GnRH and LH, promoting ovulation. Before ovulation, FSH levels peak, stimulating the ovaries and causing ovulation. Once ovulation has occurred, FSH levels return to baseline or drop slightly below normal.

2. Significance of FSH receptor gene polymorphism test in assisted reproduction

The FSH receptor gene polymorphism test is a test that allows the identification of genetic variants associated with the response to ovarian stimulation. The aim is to produce good quality embryos and increase pregnancy rates in IVF.

When ovarian stimulation is performed, depending on the response of the ovaries, the results can be classified into 4 main groups:
• Poor responder according to Bologna criteria: 3 oocytes obtained
• Sub-optimal responder: 4 to 9 oocytes obtained
• Normal responder: 10 to 15 oocytes are obtained
• Hyper-responder: ≥ 15 oocytes obtained

Therefore, the identification and classification of patients is the key to choosing the correct treatment strategy. Currently, poor response to ovarian stimulation is a matter of great concern because this is a very difficult patient group to treat in IVF.
In addition to the problems of ovarian reserve factors such as AFC secondary follicles, AMH hormones, body mass index (BMI), age of the patient, etc., many studies show that FSH receptor gene polymorphisms associated with poor ovarian response.

In Vietnam, FSH receptor gene polymorphism testing is still relatively new. However, in the world, there have been many studies showing that some FSH receptor gene polymorphisms make the amount of drugs that patients need to take more. The four SNPs that have been shown to be associated with poor ovarian response are rs6165, rs6166, rs1394205, rs10835638.
FSH receptor gene polymorphism testing will be a promising and necessary option for individualizing ovarian stimulation and obtaining optimal egg numbers for treatments.

If the patient is a carrier of the FSH receptor gene polymorphism associated with poor ovarian response, the dose of the drug will need to be increased in order to obtain the optimal number of eggs. Like this, the patient will have to stimulate more times, which means an increase in treatment costs. Therefore, we should screen at the beginning to classify the patient into which group.
The FSH receptor gene polymorphism test has been studied and proven to be associated with poor ovarian response, and supports physicians in individualizing and optimizing ovarian stimulation regimens. By performing the FSH receptor gene polymorphism test, the doctor will provide an optimal and personalized ovarian stimulation regimen for each patient, as well as assist in determining the cause of the poor ovarian response. (POR).
It can be seen that performing FSH receptor polymorphism testing is extremely important for women who are about to undergo ovarian stimulation. By performing this test, the doctor will come up with an effective treatment plan, helping infertility cases save time and costs as well as soon "harvest the sweet fruit".