What are the factors affecting IVF success in women with hypogonadotropic hypogonadism?

This study aimed to investigate in vitro fertilization (IVF) outcomes in women with hypogonadotropic hypogonadism (HH) and unexplained infertility and investigate factors affecting the pregnancy rate among HH patients.

This retrospective cohort study was conducted at Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Turkey, a tertiary care referral center. The medical records of 143 women who underwent IVF treatment at this hospital between 2015 and 2020 were reviewed. Sixty-three had hypogonadotropic hypogonadism (HH) and 74 had unexplained infertility. Demographics, hormonal profile, IVF cycle characteristics, and pregnancy rates were recorded. The factors affecting the ongoing pregnancy rates were evaluated among HH patients.

Anti-Mullerian hormone (AMH) levels were lower among women with HH compared to those with unexplained infertility (1.64±1.2 vs. 3.0±2.13). IVF cycle characteristics and ongoing pregnancy outcome (20.28% vs. 22.97%) were similar between the groups; however, the total dose of human menopausal gonadotrophin (HMG) used (5127.74±1845.8 vs. 2035.71±1387.45) was higher in the HH group. Increased estradiol level (2596.35±1085 vs. 1869.9±1203.4), endometrial thickness (10.82±1.74 vs. 8.43±2.33), higher number of total oocytes retrieved (12.14±4.34 vs. 8.43±5.44) were correlated with higher ongoing pregnancy rates among the HH group.

IVF success rates were similar between the HH and unexplained infertility groups. Although AMH level was not a prognostic factor for IVF success, higher doses of HMG were needed to achieve pregnancy in the HH group. The factors affecting the ongoing pregnancy rates in the HH group were higher estradiol level, increased endometrial thickness, and a higher number of oocytes retrieved.