Impact of FSHR -29 (G>A) Polymorphism on Ovarian Response and Pregnancy Outcomes in PCOD Patients Undergoing ART

Background: Polycystic ovary disease (PCOD) is a leading cause of anovulatory infertility, often requiring assisted reproductive technology (ART) for successful conception. Genetic polymorphisms, particularly in the follicle-stimulating hormone receptor (FSHR) gene, may influence ovarian response and reproductive outcomes. This study investigates the association of FSHR-29 (rs1394205) polymorphism with ovarian stimulation parameters, gonadotropin sensitivity, and pregnancy outcomes in PCOD patients undergoing ART. Methods: A retrospective cohort study was conducted at Krishna IVF Clinic, Visakhapatnam, analyzing 224 PCOD patients undergoing ART between July 2015 and December 2020. Participants were stratified into three genotypic groups: GG (n=107, 47.77%), GA (n=85,37.95%), and AA (n=32, 14.29%). Ovarian response, hormone administration levels, embryo quality, clinical pregnancy rates, and live birth rates were assessed. Statistical analysis included ANOVA, Kruskal-Wallis, and logistic regression models, with GG as the reference genotype. Results: AA genotype carriers exhibited higher gonadotropin requirements for ovarian stimulation (p=0.074), suggesting reduced FSH receptor expression. Despite comparable antral follicle count (AFC) and oocyte yield across genotypes, clinical pregnancy rates were highest in GG (49.53%), followed by GA (47.06%) and AA (37.50%). AA carriers also demonstrated the lowest live birth rates (21.8%) and highest rates of negative pregnancy outcomes (62.5%). However, statistical significance was not established for pregnancy or live birth outcomes. Conclusion: FSHR-29 polymorphism may influence ovarian response and reproductive success in PCOD patients undergoing ART. While AA genotype carriers required higher FSH doses, exhibited lower pregnancy rates, and had poorer live birth outcomes, the findings warrant further investigation with larger cohorts to validate clinical significance.