2019, Number 09
Cut-off value in FSH levels as a prognostic factor for oocyte yield in IVF cycles with antagonist protocol
PDF size: 303.36 Kb.
ABSTRACTBackground: Measurement of follicle-stimulating hormone (FSH) is used as a marker of ovarian reserve. The number of oocytes obtained is significantly lower among women with higher FSH levels.
Objective: To know the cut-off level of FSH and its prognostic value in the number of oocytes retrieved.
Methods: Retrospective study performed on patients in their first cycle of in vitro fertilization with an antagonist protocol. The patients were separated into two groups according to the basal FSH concentrations: group 1 FSH lower than 7 mIU / mL, group 2 with concentrations greater than 7 mIU / mL. Compared variables among groups were: age, total dose of gonadotropins, peak of estradiol, total number of oocytes retrieved, number of oocytes in metaphase II, number of embryos available for transfer, and the pregnancy rate.
Results: Group 1 included 927 women, while group 2 included 514 women. Age was lower in group 1 (34.3 vs. 35.3, p ‹0.05). In group 1 more oocytes were obtained (11.15 vs 8.26, p ‹0.05), as well as more mature oocytes (7.4 vs 5.3, p ‹0.05). There was no significant difference in pregnancy rates between both groups (27.98 vs. 28.92, p = 0.54).
Conclusions: A baseline FSH› 7 correlates significantly with obtaining fewer oocytes in IVF treatment cycles with antagonist protocols.
van Loendersloot LL, et al. Predictive factors in in vitro fertilization (IVF): a systematic review and meta-analysis. Hum Reprod Update 2010;16:577-589. DOI: 10.1093/ humupd/dmq015
Ferraretti AP, et al. ESHRE consensus on the definition of “poor response” to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod 2011;26:1616-1624. DOI: 10.1093/humrep/der092
American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril 2015;103:e9-17. DOI: 10.1016/j. fertnstert.2014.12.093
Weghofer A, et al. Age-specific FSH levels as a tool for appropriate patient counselling in assisted reproduction. Hum Reprod 2005;20:2448-2442. DOI: 10.1093/ humrep/dei076
Barad DH, et al. Age-specific levels for basal folliclestimulating hormone assessment of ovarian function. Obstet Gynecol 2007;109:1404-1410. DOI: 10.1097/01. AOG.0000264065.37661.a0
van Rooij IA, et al. Women older than 40 years of age and those with elevated follicle-stimulating hormone levels differ in poor response rate and embryo quality in in vitro fertilization. Fertil Steril 2003;79:482-488. DOI: 10.1016/ s0015-0282(02)04839-2
Fang T, et al. Predictive value of age-specific FSH levels for IVF-ET outcome in women with normal ovarian function. Reprod Biol Endocrinol 2015;13:63. DOI: 10.1186/s12958- 015-0056-6
Van Rooij IA, et al. High-follicle stimulating hormone levels should not necessarily lead to the exclusion of subfertile patients from treatment. Fertil Steril 2004;81:1478-1485. DOI: 10.1016/j.fertnstert.2003.10.054
Roberts JE, Spandorfer S, Fasouliotis SJ et al. Taking a basal follicle-stimulating hormone history is essential before initiating in vitro fertilization. Fertil Steril 2005;83:37-41. DOI: 10.1016/j.fertnstert.2004.06.062
Sabatini L, et al. Relevance of basal serum FSH to IVF outcome varies with patient age. Reprod Biomed Online 2008;17:10-19.
Esposito MA, et al. A moderately elevated day 3 SFH concentration has limited predictive value, especially in younger women. Hum Reprod 2002;17:118-123. DOI: 10.1093/humrep/17.1.118
Jurema MW, Bracero NJ, Garcia JE. Fine tuning cycle day 3 hormonal assessment of ovarian reserve improves in vitro fertilization outcome in gonadotropin-releasing hormone antagonist cycles. Fertil Steril 2003;80:1156-1161. DOI: 10.1016/s0015-0282(03)02159-9
Chuang CC, et al. Age is a better predictor of pregnancy potential than basal follicle-stimulating hormone levels in women undergoing in vitro fertilization. Fertil Steril 2003;79:63-68. DOI: 10.1016/s0015-0282(02)04562-4
Abdalla H, et al. An elevated basal FSH reflects a quantitative rather than a qualitative decline of ovarian reserve. Hum Reprod 2004;19:893-898. DOI: 10.1093/humrep/deh141
Toner JP, et al. Why we may abandon basal folliclestimulating hormone testing: a sea change in determining ovarian reserve using antimüllerian hormone. Fertil Steril 2013;99:1825-1830. DOI: 10.1016/j.fertnstert.2013.03.001