The role of gonadotropin receptor polymorphysm in the suboptimal response to ovarian stimulation for IVF

The aim of our study was to evaluate the relationship between response to ovarian stimulation and gonadotropin receptor (FSHR, LHCGR) polymorphism in patients having IVF treatment. In addition, relationship between the presence of genetic variants, receptor polymorphism, with pregnancy rates and indications of IVF were investigated as a secondary outcome measures. This retrospective study included 128 infertile patients who underwent NGS infertility panel test and IVF treatment at Gazi University Faculty of Medicine Assisted Reproductive Techniques Center and Novaart IVF and Women's Health Center between January 2018 and December 2020. Archived data of demographic and treatment cycle characteristics, pregnancy rates and NGS were used. Presence of genetic variant, receptor polymorphism were analysed based on demographic characteristics, ovarian response to stimulation and pregnancy outcomes. There was no significant difference in the comparison of the demographic characteristics of the patients according to whether they have genetic variant or not (p>0.05). Basal FSH level was found to be higher in the group with receptor polymorphism (p=0.046). When the ovarian response was evaluated separately as FOI and FORT, there was no statistically significant difference between the groups of decreased and normal FOİ and FORT regarding presence of genetic variant, receptor polymorphism, FSHR and LHCGR polymorphism (for FOI p=0.71, p=0.21, p=0.61, p=0,29, respectively; for FORT p=1, p=1, p=0.31, p=0.57, respectively). In comparison between patients with and without pregnancy, no statistically significant difference was found regarding genetic variant, receptor polymorphism, FSHR and LHCGR polymorphism (p= 0.34, p=0.44, p=0.57, p=1, respectively). The rates of genetic variant and receptor polymorphism were also similar between patients with and without ovulatory factor (p=0.60, p=0.70, respectively). Since the incidence of genetic variants and gonadotropin receptor polymorphisms is low in this population and ovarian response to stimulation and pregnancy outcomes were not influenced by gonadotropin receptor polymorphysim, there is no need to perform routine these genetic tests with NGS in patients undergoing IVF.