FSH

- 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 reach their peak, stimulating the ovaries and causing ovulation. Once ovulation has occurred, FSH levels return to baseline or drop slightly below normal levels.

- The Poor/Low Ovarian Response group is a group of women with impaired response to gonadotropins. Therefore, a higher dose of gonadotropin or longer stimulation is required to obtain the required number of oocytes. The estimated incidence of poor ovarian response (POR) ranges from 9 to 24%.

- The incidence of mild ovarian hyperstimulation syndrome (OHSS) is common in women undergoing IVF; affects 33 out of 100 women (33%). However, just over 1 in 100 women (1%) will develop moderate or severe OHSS.

Lee, H.J., Noh, H.K. & Joo, J.K. Comparison of ART outcome in patients with poor ovarian response according to POSEIDON criteria. Sci Rep 12, 17723 (2022). https://doi.org/10.1038/s41598-022-22859-w.

Mã, P. Q. M., Lê, L. H., Phạm, T. Q., Hồ, M. T., & Vương, T. N. L. (2019). Mối tương quan giữa đa hình gen thụ thể FSH và đáp ứng kích thích buồng trứng cận tối ưu trên nhóm phụ nữ thực hiện IVF tại việt nam . Tạp Chí Phụ sản, 17(1), 75 -. https://doi.org/10.46755/vjog.2019.1.598

FSH receptor gene polymorphism testing allows the identification of genetic variants associated with the response to ovarian stimulation. Specifically:

• FSHR: rs6165, rs6166, rs1394205
• FSHB: rs10835638

rs6165 polymorphism:

- Allele G at position 919 (c.919G>A)

=> Ala307Thr

=> 307Ala/Ala (G/G) variant associated with poor ovarian response

rs6166 polymorphism:

- Allele G at position 2039 (c.2039G>A)

=> Ser680Asn

=> Variant 680Ser/Ser (G/G) associated with poor ovarian response

rs1394205 polymorphism:

- SNP is located in the promoter region of the FSHR gene (c.-29G>A)

=> A/A variant associated with poor ovarian response

Polymorphism rs10835638:

- The SNP is located in the promoter region of the FSHB gene (c.-211G>T)

=> T/T and G/T variants associated with poor ovarian response

Sample: 2-3 ml of whole blood in an EDTA anticoagulant tube.

Subjects of patients: Women preparing for ovarian stimulation (COH)

Technique: Sanger and NGS sequencing on Miseq/Nextseq sequencer system and capillary electrophoresis machine.

Time to return results: 5-7 days

Sensitivity, specificity of analytical methods: > 99%

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