Follicular reserve and response to stimulation. Molecular genetic aspects

Ovarian response to stimulation therapy and the timing of follicular depletion vary substantially between individual patients. Both factors are of outstanding importance for the performance and outcome of infertility therapy. Besides established clinical markers, the analysis of genetic variants may be of use as a prognostic tool in the near future. Clinical studies on the p.N680S-polymorphism of the FSH receptor gene have demonstrated the homozygous Ser/Ser variant to be less sensitive to endogenous or exogenous FSH in terms of estradiol production. Prospective genotyping before stimulation therapy could therefore individualize the FSH dose to the patients' requirements and improve the balance between adequate ovarian response and unwanted side effects. Furthermore, the identification and analysis of other candidate genes could shed light on the variable timing of follicular reserve and depletion. © Springer Medizin Verlag 2006.