Abstract

Background: PCOS patients often require ovulation induction due to infertility. However, it is observed in practice that some of these patients do not respond despite multiple attempts. Anti-gonadotropin antibodies are believed to be responsible. The goal of this study was to estimate the response of women with PCOS and positive anti-gonadotropin antibodies to the induction of ovulation.
Methodology: A prospective study was conducted at Basra Maternity and Child Hospital from January 2019 to November 2021. The study included 73 women with PCOS. The diagnosis of PCOS was based on amenorrhea, signs of hyperandrogenism, as well as typical sonographic findings in PCOS. The male factor was excluded in all selected cases. Three cycles of parental gonadotropin were administered to all women. Individual blood samples were collected, and ovulation monitoring was performed. Anti-FSH and Anti-LH levels were detected by the ELISA technique. Statistical analysis was carried out using SPSS.
Results: The total number of samples evaluated was 73, with ages ranging from 20 to 36. Based on sonographic evaluation of follicle size, hormonal levels and demographic characteristics, 44 cases were classified as good responders, and 29 cases as poor responders. It seems that age is a significant factor between the two groups. There was a statistically significant difference in the level of FSH and LH between the two groups on day three of the cycle. The duration of infertility and the number of treatment cycles did not affect the outcome in either group. Anti-FSH antibodies were much higher in poor responders compared to good ones, while the level of anti-LH antibodies was marginally significant between the two groups. The level of anti-gonadotropin antibodies in the present study was not significantly influenced by BMI.
Conclusions: The anti- gonadotropin antibodies affect the response to ovulation induction in women with PCOS. It seems that the age as well as the basal level of FSH and LH are significant factors among the good and poor responders. Poor responders have a significantly higher level of anti-FSH, which affects fertility adversely.