The Correlation of Basal Serum FSH, Antral Follicle Count with Ovarian Response in Women with Advanced Reproductive Age (original) (raw)
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Journal of assisted reproduction and genetics, 2000
Basal follicle-stimulating hormone (FSH) and age are predictors of successful outcome in in vitro fertilization (IVF). More recently, the clomiphene citrate challenge test (CCCT) has been proposed as a better way to predict IVF outcome than FSH alone. The purpose of this study was to determine which indicator of ovarian reserve--basal (day 3) FSH or the CCCT--is the better predictor of IVF success in the critical age group of women over the age of 40. In this retrospective study, basal FSH and clomiphene-stimulated FSH levels from 104 women who underwent 175 cycles of IVF were analyzed. Neither basal FSH level nor stimulated FSH level alone were statistically significant predictors of IVF success; however, no patient with a day 3 FSH level > 11.1 mIU/ml or a stimulated day 10 FSH level > 13.5 mIU/ml conceived and carried a pregnancy. All ongoing pregnancies occurred in the first two cycles of IVF. Clear prognostic cutoff values were found to predict IVF success in women over a...
Obstetrical Gynecological Survey, 2003
Objective: To investigate whether IVF outcome of patients older than 40 years of age with basal FSH levels less than 15 IU/L differs from that in patients 40 years of age or younger with basal FSH levels of 15 IU/L or greater. Design: Prospective observational study. Setting: Tertiary academic fertility center. Patient(s): Women 41 years of age or older with basal FSH levels less than 15 IU/L (n ϭ 50), and women 40 years of age or younger with elevated basal FSH levels (n ϭ 36) undergoing their first IVF cycle. Intervention(s): IVF treatment using a long suppression protocol with recombinant FSH at a fixed starting dose of 150 IU/L. Main Outcome Measure(s): Ovarian response, ongoing pregnancy rates, and implantation rates. Result(s): The high FSH group experienced more cycle cancellations due to absent follicular growth than did the high age group (31% vs. 8%). However, the high FSH group had better implantation rates per embryo (34% vs. 11%), higher ongoing rates per ET (40% vs.13%), and higher ongoing pregnancy rates per cycle (25% vs. 10%). In both groups, poor responders had lower pregnancy rates. Conclusion(s): The outcome of IVF differs between patients older than 40 years of age with normal FSH levels and relatively young patients with elevated FSH levels. This finding may have implications for the management of these patients.
Fertility and Sterility, 2003
To analyze to what extent the parameters of ovarian functional reserve including female age and basal FSH levels will affect the results of ovarian hyperstimulation and IVF outcome. Design: Retrospective cohort study. Setting: University hospital infertility center. Patient(s): One thousand forty-five women undergoing their first cycle of IVF with ovarian stimulation after pituitary desensitization. Intervention(s): None. Main Outcome Measure(s): Cycle parameters, cancellation rate, implantation rate, and pregnancy rate. Result(s): Both increasing age and basal FSH were associated significantly with reduced numbers of oocytes collected, oocytes fertilized, and embryos transferred. The combined use of age and basal FSH significantly improves the predictive power for these parameters. Increasing age, but not basal FSH, was associated significantly with reduced implantation rate and pregnancy rate. Logistic regression analysis revealed that age, but not basal FSH, was an independent predictor of pregnancy rate. Neither age nor basal FSH had significant association with fertilization rate, miscarriage rate, or ectopic pregnancy rate. Conclusion(s): Both basal FSH and age contributed to the prediction of the quantitative ovarian reserve as reflected by the number of oocytes collected. However, age is a better predictor of pregnancy potential for women undergoing IVF. (Fertil Steril 2003;79:63-8.
Human Reproduction, 2002
BACKGROUND: The present study addresses the issue of biological ageing of the oocyte (as indicated by basal serum FSH levels) versus chronological ageing. METHODS: 1019 infertile but ovulating women were studied in their first cycle of IVF treatment. A series of logistic regression models were developed to assess statistical significance of effects of age and FSH on implantation rates and live babies born. RESULTS: The number of oocytes retrieved and embryos available for transfer declined with increasing age and basal serum FSH concentrations. Fertilizing ability of oocytes increased with advancing age but was not affected by FSH concentrations. Although the number of oocytes or embryos available for transfer had no independent effect on implantation rates, the implanting ability of fertilized oocytes (embryos) was inversely related to increasing age and independently to FSH. The chance of a baby being born, however, was determined more by age than by serum FSH. CONCLUSIONS: Ovarian ageing affecting oocyte quality and fecundity can occur independently of chronological age. This has important practical implications whereby serum basal FSH measurement may be a valuable prognostic index, though chronological age remains important.
Poor ovarian response as a predictor for live birth in older women undergoing IVF
Reproductive biomedicine online, 2018
Women of advanced age present a major challenge for fertility treatments. This study was designed to assess whether poor ovarian response (POR) according to the Bologna criteria is a significant predictor for live birth in women over 40. The outcomes of subsequent IVF cycles were also studied. The results of 1870 fresh IVF cycles in 1212 women were retrospectively analysed. The live birth per cycle was 3.3 times higher (11.61% versus 3.54%, P < 0.001) in good responders with more than three oocytes collected compared with women with less. Ovarian response defined by oocytes collected, but not by the number of follicles, was independently associated with live birth (odds ratio, 2.0; 95% confidence interval, 1.18 to 3.54; P = 0.009). The occurrence of POR in subsequent IVF cycles was only 55%. No differences in live births were found in persistent POR compared with women with at least one good response. A single episode of POR in a first IVF cycle in older women has a limited predi...
JBRA assisted reproduction, 2018
Objective: Ovarian reserve evaluation has been the focus of substantial clinical research for several years. This study aimed to examine the associations between markers of ovarian reserve and ovarian response. Methods: This prospective study included 132 infertile women aged 24-48 years undergoing routine exploration during unstimulated cycles prior to the start of assisted reproductive technology (ART) treatments at our center from July 2015 to January 2017. Descriptive parameters and patient characteristics were reported as mean (SD) or median (range) values depending on the data distribution pattern. Student's t-test was performed for continuous variables; the Wilcoxon and Pearson's test were used for data not following a normal distribution; and Fisher's test was used for categorical variables. p<0.05 was considered statistically significant. Results: At the time of the study, the patients had a mean age of 35.7±3.84 years. On day 3 of the cycle, the mean anti-Müllerian hormone (AMH) serum level was 2.84±1.57 ng/mL and the patients had 14.68±4.2 antral follicles (AFC). A significant correlation was observed between AMH and age (r=-0.34 p<.01), follicle stimulating hormone (FSH) serum levels (r=-0.32, p<.01), AFC (r=0.81, p<.00001), total dose of medication during ovarian stimulation (r=-0.28, p<.0003), and ongoing pregnancy rate (p<.05). Age was significantly correlated with FSH (r=0.46, p<.01), AFC (r=-0.34, p<.00001), total dose of medication during ovarianstimulation (r=0.43, p<.0003), and ongoing pregnancy rate (p<.04). Conclusion: Serum AMH and age are independent predictors of ovarian reserve and ovarian stimulation outcome in infertile women. Age and serum AMH level may be used to advise subfertile couples of their pregnancy prospects.
Improvements in IVF in women of advanced age
Journal of Endocrinology, 2016
Women above age 40 years in the US now represent the most rapidly growing age group having children. Patients undergoing in vitro fertilization (IVF) are rapidly aging in parallel. Especially where egg donations are legal, donation cycles, therefore, multiply more rapidly than autologous IVF cycles. The donor oocytes, however, are hardly ever a preferred patient choice. Since with use of own eggs, live birth rates decline with advancing age but remain stable (and higher) with donor eggs, older patients always face the difficult and very personal choice between poorer chances with own and better chances with donor oocytes. Physician contribution to this decision should in our opinion be restricted to accurate outcome information for both options. Achievable pregnancy and live birth rates in older women are, however, frequently underestimated, thereby mistakenly biasing fertility providers, private insurance companies and even regulatory government agencies. Restriction on access to I...