Luteinising Hormone-to-follicle-stimulating Hormone Ratio for Predicting Unexplained Infertility in Patients with Hypovitaminosis D.

Background

Hypovitaminosis D critically influences reproductive hormones in women of reproductive age. The luteinising hormone (LH)/follicle-stimulating hormone (FSH) ratio predicts poor ovulatory response.

Objective

To evaluate the correlation between the LH/FSH ratio and hypovitaminosis D as a predictor of unexplained infertility in women.

Materials And Methods

The study was a cross-sectional study with retrospective data collection spanning 2 years, from January 2023 to December 2024, conducted in the Fertility and Gynecology of El Assrar Center of Oran (Algeria). Patients were segregated into the following groups (deficient group vs. insufficient group vs. sufficient group).

Results

During the study period, 200 patients were admitted. Hypovitaminosis D status was observed in 44.5%. The mean age was 32.24 ± 6.39 years (range: 18-47). In the deficient group, serum LH concentrations were markedly lower compared to the insufficient and sufficient groups (LH = 5.80 ± 3.31 UI/L vs. 8.83 ± 6.90 UI/L vs. 6.48 ± 4.00 UI/L, P = 0.018; respectively). In contrast, the LH/FSH ratio was statistically higher in the deficient group compared to the insufficient and sufficient groups (LH/FSH ratio = 1.67 ± 1.88 vs. 0.94 ± 0.59 vs. 1.02 ± 0.64, P = 0.018; respectively). In addition, the results revealed that the 4th quartile (odds ratios = 11.37 [4.13-22.00], P = 0.021) of LH/FSH ratio was statistically higher in patients with Vitamin D insufficiency and deficiency. The LH/FSH ratio was a significant predictor for unexplained infertility with a diagnostic accuracy of 0.724.

Conclusions

Elevated LH/FSH ratio in women with hypovitaminosis D is significantly linked to unexplained infertility. Therefore, the LH/FSH ratio can serve as a reliable clinical marker for predicting successful pregnancy when evaluated alongside Vitamin D levels.