Basal FSH concentrations as marker of ovarian aging are not related to pregnancy outcome in a general population of women over 30 years (original) (raw)
Related papers
Endocrine Journal, 2001
An elevation in follicle-stimulating hormone (FSH) levels is considered to reflect lowered ovarian function, resulting in poor fecundity in infertile women. However, it remains to be clarified whether or not the significance of FSH levels applies equally to all women irrespective of age. The objective of the present study is to compare basal FSH levels in infertile women who conceived or not after stratification by age. A total of 144 infertile women between ages 25 and 45 who underwent infertility treatment due to unexplained infertility in the University of Tokyo Hospital were included in the retrospective study. Subjects were divided by age into two groups, <38 (n=98) vs?38 (n=46) years, with ages ranging from 25 to 37, and from 38 to 45, respectively. Blood samples were collected in early follicular phase (day 4-6) for assessment of basal levels of LH, FSH, and PRL. In the older group, pregnant cases had significantly lower FSH levels (6.07±2.83 mIU/ml) than nonpregnant cases (9.60±3.67 mIU/ml), whereas no difference in basal FSH levels was observed between pregnant and nonpregnant cases in the younger group. Basal FSH levels of pregnant cases in the older group were significantly lower than those of pregnant cases in the younger group (8.26±2.95 mIU/ml). Basal LH and PRL levels were not related to fecundity in either group. Thus, an increase in basal FSH levels as a predictor of fecundity should be considered in the context of age.
Bangladesh Journal of Obstetrics & Gynaecology, 2016
Female age has consistently been shown to be the most important predictor of success in assisted reproductive technologies. There have been numerous reports in last twenty years showing the age-related effect on the results of IVF treatment in infertile couples. Templeton 1 in 1996 first demonstrated that the probability of live birth obtained through IVF treatment clearly decreases after the age of 35. Over the past two decades, a number of hormonal markers and imaging tests have been studied for their ability to predict outcome of IVF in terms of oocyte
DOES AMH AND FSH PREDICT OVARIAN RESERVE AND CHANCE OF SUCESSFUL PREGNANCY
Societal and behavioral shifts in recent years have resulted in a trend towards delayed child bearing which has lead to increase in infertility from 6% in women aged between 15-24 years to Less than 30% in the age group of 35 -44 yrs old .This has created a demand from patients & clinicians for a method to monitor fertility.
Trisomic pregnancy and elevated FSH: implications for the oocyte pool hypothesis
Human Reproduction, 2011
background: Some studies, but not all, support the hypothesis that trisomy frequency is related to the size of the oocyte pool, with the risk increased for women with fewer oocytes (older ovarian age). We tested this hypothesis by comparing hormonal indicators of ovarian age among women who had trisomic pregnancy losses with indicators among women with non-trisomic losses or chromosomally normal births. The three primary indicators of advanced ovarian age were low level of anti-Müllerian hormone (AMH), high level of follicle-stimulating hormone (FSH) and low level of inhibin B.
Elevated day 3 serum follicle stimulating hormone and/or estradiol may predict fetal aneuploidy
Fertility and Sterility, 1999
To determine whether baseline serum FSH and/or E 2 concentrations can predict the risk for fetal chromosomal abnormalities. Design: Case control study. Setting: Reproductive technology program at a university hospital. Patient(s): Patients who underwent dilation and curettage (D ϩ C), and whose products of conception were karyotyped. Intervention(s): Patients underwent natural conception or controlled ovarian hyperstimulation followed by intrauterine insemination, in vitro fertilization and embryo transfer, gamete intrafallopian transfer, or zygote intrafallopian transfer. Main Outcome Measure(s): Baseline serum FSH and E 2 concentrations and fetal karyotype. Result(s): Genetic evaluation of 78 D ϩ C specimens revealed 34 normal and 44 abnormal fetal karyotypes. A significantly greater proportion of women with abnormal fetal karyotype had elevated baseline serum FSH (Ն15 mIU/mL [RIA] or 10 mIU/mL [Immulite]) and/or E 2 (Ն50 pg/mL [Immulite]) compared with women of normal fetal karyotype. Among karyotypically abnormal abortuses, autosomal trisomy was the most common abnormality noted (79.5%), followed by mosaicism (6.8%), triploidy (6.8%), monosomy XO (4.5%), and balanced translocation (2.3%). Conclusion(s): Baseline serum FSH and/or E 2 concentrations may be valuable as predictors of fetal aneuploidy. (Fertil Steril 1999;71:715-8.
Reproductive BioMedicine Online, 2006
The aim of this study was to determine the value of basal FSH as a predictor of assisted reproduction outcome in women &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=35 years undergoing ovarian stimulation with gonadotrophin-releasing hormone (GnRH) antagonist. A retrospective clinical study was carried out on 83 infertile women, 35-45 years old, divided into three groups according to their day 3 FSH concentration (group A = FSH &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;or=10 mIU/ml, group B = FSH &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;10 and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;15 mIU/ml, group C = FSH &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;15 mIU/ml). Patients underwent ovarian stimulation with a GnRH-antagonist protocol. Group A women had significantly higher basal inhibin B concentrations (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), lower cancellation rate (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), required a significantly lower dosage of recombinant FSH (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and had significantly higher oestradiol concentration under stimulation compared with the other groups (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Oocyte and embryo numbers were comparable in all groups, although groups B and C had more low quality embryos compared with group A. The number of metaphase II oocytes and embryos was related to patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; ovarian reserve markers only in group C. Pregnancy and delivery rates were 35 and 22.5% in group A, 22.2 and 16.6% in group B and 5 and 0% in group C. It is concluded that a basal FSH cut-off of 10 mIU/ml seems predictive of ovarian reserve, while basal FSH cut-off of 15 mIU/ml seems predictive of pregnancy potential and probably of oocyte quality.
Basal follicle-stimulating hormone as a predictor of fetal aneuploidy
Fertility and Sterility, 2008
Objective: To determine whether an elevated basal FSH concentration is an independent predictor of fetal aneuploidy, as measured in spontaneous abortions (SAB). Design: Retrospective study. Setting: Academic reproductive endocrinology and infertility center. Patient(s): All women with karyotypes of chorionic villi isolated from first trimester spontaneous miscarriages at the time of dilation and curettage from 1999 to 2006. The highest basal serum FSH level in the year preceding dilation and curettage was recorded. Interventions(s): Monitoring of early pregnancy. Main Outcome Measure(s): Fetal karyotype.
Waiting for an elevated FSH - Too late a marker of reduced ovarian reserve?
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2012
Aim: To assess age at which median follicle-stimulating hormone (FSH) is elevated above 10 U/L. Background: Fertility and ovarian reserve decrease over the 4th decade with evidence that sensitive markers such as anti-Mullerian hormone fall even earlier. Despite its limitations, a basal or day 2-3 FSH is commonly used to assess ovarian reserve with levels over 10 U/L often used as a cut-point for further investigations. Methods: Women referred to a community laboratory for 'hormone testing', including FSH and oestradiol (n = 40 254), were included in a retrospective analysis. Cases excluded were those with suppressed FSH (<1 U/L) who were likely on the oral contraceptive pill or pregnant and those with increased oestradiol (>500 pmol/L) who were likely approaching mid-cycle or pregnant. Remaining cases (n = 32 445) were analysed in five-year age bands for FSH median, mean, and 2.5 and 97.5 percentiles. Results: Median FSH remained consistently low (5 U/L) in women 35 years of age and was 6 U/L in 35-to 40year-olds. The mean FSH and 97.5 percentile increased steadily. The 97.5th percentile was 10 U/L or lower in women up to 30 years of age. Conclusions: Follicle-stimulating hormone is a late indicator of known reducing ovarian reserve, and in this study, median FSH did not increase over 10 U/L until >45 years of age. FSH levels >9 U/L were above the 97.5th percentile in those <25 years of age. If fertility is a concern, FSH levels persistently above age-specific medians in women under 40 years may prompt earlier follow-up with more sensitive tests for ovarian reserve.
Human Reproduction, 2003
BACKGROUND: During the course of assisted reproduction treatment, a number of women exhibit a`poor response' to ovulation induction, or demonstrate an elevated basal FSH level (b10 IU/l) at a young age. We sought to determine whether these women are at increased risk of early menopause and poor reproductive performance. METHODS: A retrospective cohort study included 118`poor responders' with normal basal FSH level (<10 IU/l), 164 women with raised basal FSH (b10 IU/l), and 265 controls, who underwent assisted reproduction treatment between 1987 and 1998. All women were <40 years of age at the time of treatment and had normal menstrual cycles. Participants were sent a postal questionnaire in 2000±2001, seeking information on ovarian function and reproductive performance following cessation of treatment. RESULTS: After adjusting for age and smoking habits, women with poor response and raised basal FSH levels were more likely to experience symptoms of the peri-menopause [hazard ratios 2.4, 95% con®dence interval (CI) 1.52±3.78, and 2.76, 95% CI 1.78±4.29 respectively, P = 0.0001]. Poor responders were six times and 23 times more likely to experience the menopause within 10 years of treatment than those with raised basal FSH levels and controls respectively (hazard ratio 5.97 and 23.9, P = 0.015 and 0.002 respectively). Poor responders and those with raised basal FSH levels have half the chance of spontaneous conception after discontinuation of treatment compared with controls (P < 0.007). CONCLUSIONS: Both poor response to ovarian stimulation and raised basal FSH are markers of reduced ovarian reserve and predict an increased risk of early menopause.
Journal of Assisted Reproduction and Genetics, 2000
Purpose : Chronological age, or biological age as indicated by elevated FSH levels, are related to ovarian reserve. This study addresses the likelihood of cancellation of IVF treatment due to a poor ovarian response utilising both basal serum FSH and woman's age. Methods : A prospective cohort of 536 infertile but ovulating women were studied in their first cycle of IVF treatment. Standardised methods of pituitary desensitisation and ovarian stimulation prior to IVF treatment were employed. Treatment cycles cancelled due to a poor ovarian response to gonadotrophins were studied. A series of logistic regression models were used to explore the probabilities of cancellation in relation to age and FSH. Results : Both age and basal serum FSH levels were independently associated with the risk of treatment cancellation. A low risk of treatment cancellation was observed in women under the age of 35 irrespective of serum FSH, however in older women the risk of treatment cancellation was most likely in women with a high FSH. Conclusions : In combination both age and FSH may serve as a valuable indicator of poor ovarian response leading to treatment cancellation. However, among older women FSH has particular importance, while less so in younger women with regular menstrual cycles.