Repeated testing of basal FSH levels has no predictive value for IVF outcome in women with elevated basal FSH

ISSN： 1460-2350

Source： Human Reproduction, Vol.21, Iss.1, 2006-01, pp. : 171-174

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Abstract

BACKGROUND: It is a common practice to repeatedly test the level of basal FSH early in the cycle and to start IVF treatment only when the FSH level is below a certain threshold value. This is based on the idea that these women will respond better to ovarian stimulation when the basal FSH level is lower at the start of the cycle. The aim of this study is to assess the value of this practice. METHODS: Between January 1995 and January 2003, 39 women were identified. These women underwent two IVF treatment cycles within a 12 month period. The basal FSH level prior to each of these cycles was known to have changed. The treatment cycles were divided into cycles with a high basal FSH (≥10 IU/l) and cycles with a low basal FSH (<10 iu/l).="" results:="" the="" 39="" women="" underwent="" a="" total="" of="" 78="" treatment="" cycles="" (in="" the="" first="" cycle="" 20="" had="" elevated="" level="" of="" fsh="" and="" 19="" had="" low="" fsh="" and="" vice="" versa="" in="" the="" second="" cycle).="" therefore,="" there="" were="" 39="" cycles="" with="" high="" fsh="" and="" 39="" cycles="" with="" low="" fsh.="" there="" was="" obviously="" no="" live="" birth="" in="" the="" first="" treatment="" cycle,="" hence="" the="" reason="" for="" the="" patient="" undergoing="" another="" treatment="" cycle="" within="" 12="" months="" of="" the="" first="" one.="" in="" the="" high="" fsh="" group,="" six="" became="" pregnant="" [pregnancy="" rate="" (pr)="15.4%]" and="" five="" delivered="" [live="" birth="" rate="" (lbr)="12.8%]." in="" the="" low="" fsh="" group,="" three="" became="" pregnant="" (pr="7.7%)" and="" two="" delivered="" (lbr="5.1%)." the="" difference="" in="" pr="" and="" lbr,="" however,="" was="" not="" significant.="" neither="" were="" there="" significant="" differences="" between="" the="" two="" groups="" with="" regard="" to="" the="" number="" of="" oocytes="" collected,="" oocytes="" fertilized,="" embryos="" transferred="" or="" miscarriage="" rate.="" conclusion:="" the="" results="" of="" this="" study="" reveal="" that="" women="" who="" are="" poor="" responders="" or="" with="" reduced="" ovarian="" reserve="" have="" a="" poor="" outcome="" and="" repeatedly="" testing="" them="" will="" add="" no="" value.="" cycling="" women="" with="" a="" history="" of="" elevated="" fsh="" should="" be="" offered="" treatment="" without="" further="" delay.="" delaying="" treatment="" for="" these="" women="" could="" be="" counterproductive,="" as="" they="" may="" have="" to="" wait="" for="" many="" months,="" during="" which="" time="" they="" are="" getting="" older="" and="" closer="" to="" their="" menopause.="">