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Fertil Steril. 2007 Apr;87(4):782-7. Epub 2007 Jan 4.

Moderately elevated levels of basal follicle-stimulating hormone in young patients predict low ovarian response, but should not be used to disqualify patients from attempting in vitro fertilization.

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1
Department of Obstetrics and Gynecology, Mount Sinai School of Medicine, New York, New York, USA.

Abstract

OBJECTIVE:

To evaluate and compare IVF outcomes of patients within different age categories who had a normal basal FSH level with outcomes of patients with an elevated day 3 FSH level.

DESIGN:

Retrospective analysis.

SETTING:

Large, private IVF center.

PATIENT(S):

We analyzed 2,708 patients. Of these, 2,477 had normal basal FSH levels, and 231 had elevated basal FSH levels (> or =13.03 IU/L). Patients were segregated into various age groups.

INTERVENTION:

Follow-up.

MAIN OUTCOME MEASURE(S):

Outcomes of IVF overall, including cancellation rates, oocyte yield, and fertilization, implantation, and clinical pregnancy rates (PRs).

RESULT(S):

Cancellation rates were significantly higher in patients with elevated day 3 FSH levels compared with patients with normal FSH levels in all age groups. A significantly lower oocyte yield was observed in patients with elevated basal FSH. Fertilization rates were not affected by FSH levels. A significant decrease in the number of embryos available for transfer in patients > or =38 with an elevated day 3 FSH level was found. Implantation and clinical PRs were lower in patients >40 years of age who had an elevated day 3 FSH level when compared to same age patients with a normal day 3 FSH level. Loss rates were not significantly different.

CONCLUSION(S):

Young women with an elevated basal FSH level should be counseled differently than older women, and should be given adequate counseling and granted the opportunity to undergo an IVF cycle.

[Indexed for MEDLINE]

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