Molecular and genetic predictors of ovarian response in vitro fertilization programs

Abstract

The most effective method of treating infertility is in vitro fertilization, the key element of which is ovarian stimulation. Ovarian response in IVF protocols has varying variability among patients. The ovarian response depends on many factors, but none of these factors has sufficient prognostic ability, and therefore the question of the individual ovarian response during stimulation in IVF programs still remains open, and the association of the ovarian response with polymorphisms of certain genes is being actively studied. The most effective IVF programs are observed among patients of young reproductive age. A decrease in the effectiveness of IVF programs and the appearance of complications is observed in patients of advanced reproductive age. Several types of ovarian response have been identified: poor (it is possible to obtain 3 oocytes), normal (from 4 to 15 oocytes), suboptimal response (less than 7 oocytes) and hyperergic response (more than 15 oocytes). Also, there is a group of patients of various age groups with a paradoxical ovarian response to stimulation. The response of oocytes to hormones can be regulated depending on the expression of receptor genes. FSH receptor (FSHR) polymorphism may explain interindividual variability in ovarian response to stimulation. Genetic screening is determined once and does not depend on endogenous and exogenous factors, while allowing you to adjust the dose of gonadotropins in ovarian stimulation protocols. This review presents current data on the polymorphism of the main genes that regulate the ovarian response in stimulating superovulation in in vitro fertilization programs.