Age is a better predictor of pregnancy potential than basal follicle-stimulating hormone levels in women undergoing in vitro fertilization

Chuang, Chih Chi; Chen, Chin-Der; Chao, Kuang Han; Chen, Shee‐Uan; Ho, Hong Nerng; Yang, Yu Shih

doi:10.1016/s0015-0282(02)04562-4

Cited by 131 publications

(78 citation statements)

References 20 publications

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“…Three studies reported solely on the prediction of poor response (39,40,43), 5 solely on the prediction of pregnancy (36,37,41,42,45), and 3 reported on the prediction of both outcomes (16,38,44).…”

Section: Search Strategymentioning

confidence: 99%

Antral follicle count in the prediction of poor ovarian response and pregnancy after in vitro fertilization: A meta-analysis and comparison with basal follicle-stimulating hormone level

Hendriks

Mol

Bancsi

et al. 2005

Fertility and Sterility

340

191

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Result(s):We identified 11 studies on AFC and an updated total of 32 studies on basal FSH from the literature on the basis of preset criteria. The estimated summary receiver operating characteristic (ROC) curves showed AFC to perform well in the prediction of poor ovarian response. Also, prediction of poor ovarian response seemed to be more accurate with AFC compared with basal FSH. The estimated summary ROC curves for the prediction of nonpregnancy indicated a poor performance for both AFC and basal FSH. Conclusion(s):Transvaginal ultrasonography is an easy-to-perform and noninvasive method that provides essential predictive information on ovarian responsiveness. The predictive performance of AFC toward poor response is significantly better than that of basal FSH. Therefore, AFC might be considered the test of first choice in the assessment of ovarian reserve prior to IVF. (Fertil Steril 2005;83:291-301 Reproductive aging is associated with a reduction of the primordial follicle pool and loss of oocyte quality (1). The number of follicles leaving the pool of resting follicles to enter the growth phase toward the antral stages of development decreases with increasing age (2).In an IVF program, ovarian aging is characterized by decreased ovarian responsiveness to gonadotropin administration and lowered pregnancy rates. Correct identification of patients at risk of poor ovarian response by assessment of ovarian reserve before entering an IVF program is important.It can help physicians to tailor their advice to individual couples and help patients to decide whether to proceed with a costly and often demanding and disappointing IVF treatment.A recent meta-analysis on the performance of basal FSH level in the prediction of poor ovarian response and failure to become pregnant after IVF showed that a possible clinical application of basal FSH refers to only a minority of patients with extremely high basal FSH levels (3). However, to date basal FSH is still widely used in many fertility centers.Several other endocrine ovarian reserve tests have been proposed as predictors for IVF outcome in the past decade (4). In the field of quantitative ultrasonography, achievements in the development of tests that assess ovarian reserve have also been reported. After the initial reports by Reuss et al. (5) and Scheffer et al. (6) that transvaginal ultrasonography could detect age-related decreases in follicle counts,

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Section: Search Strategymentioning

confidence: 99%

Antral follicle count in the prediction of poor ovarian response and pregnancy after in vitro fertilization: A meta-analysis and comparison with basal follicle-stimulating hormone level

Hendriks

Mol

Bancsi

et al. 2005

Fertility and Sterility

340

191

View full text Add to dashboard Cite

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“…Stimulation usually commences about 2 weeks later, when the endometrium from the run-in cycle has been shed as well. There is flexibility in the scheduling at this stage as a few more days of downregulation do not affect the subsequent stimulation or cycle outcome to any significant degree (26). Some women will experience hypoestrogenic side effects of varying severity during this time.…”

Section: Agonistsmentioning

confidence: 99%

GnRH analogues: applications in assisted reproductive techniques

Hayden

2008

European Journal of Endocrinology

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The ability to prevent an endogenous LH surge revolutionised the efficacy of assisted reproductive techniques (ART) such that GnRH agonists were rapidly adopted in the 1980s. Prior to this, premature luteinisation occurred in up to 25% of superovulated cycles leading to cycle cancellation and severely compromised outcomes. Analogues have been applied in a variety of drug protocols (long, short flare) but there has been little research to moderate the degree of pituitary suppression. There has also been ongoing and unresolved debate about the role of LH in supporting follicular development.By 2001, the first GnRH antagonists were registered for use in ART. Their ability to cause immediate suppression of gonadotrophin (particularly LH) secretion means that they can be given after exogenous stimulation has begun and thereby dramatically shorten the total duration of a treatment cycle. After initial enthusiasm and then scepticism that pregnancy rates may not be as high as the established agonist regimens, these preparations are now being increasingly adopted with at least comparable outcomes in large trials. They are certainly favoured by patients for their reduced side-effect profile and particularly for the shortening of the total cycle length. This shift in practice is occurring alongside gathering momentum in favour of milder stimulation protocols and a new perception of what constitutes successful treatment. The focus is moving away from surrogate outcomes such as oocyte numbers and conception rates towards long-term outcomes for women and their offspring, namely the achievement of a live singleton birth per treatment started.

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“…In a multivariate analysis of factors predicting the success of live births after IVF, Minaretzis et al 182 reported that previous pregnancies and the number of embryos transferred, correlated positively, while maternal age was negatively correlated with live birth. These conclusions could basically be confirmed by Hunault et al 183 and Chuang et al 184 In addition, there is evidence for a predictive value of the number of retrieved oocytes and an embryo score of the transferred embryos for ongoing pregnancy. 183,185 Our observation that maternal age is most important for the prediction of the embryo quality corresponds with these ideas.…”

Section: Discussionmentioning

confidence: 61%

Sperm function and assisted reproduction technology

Henkel¹,

Maass²,

Bödeker³

et al. 2005

Reprod Med Biol

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The evaluation of different functional sperm parameters has become a tool in andrological diagnosis. These assays determine the sperm's capability to fertilize an oocyte. It also appears that sperm functions and semen parameters are interrelated and interdependent. Therefore, the question arose whether a given laboratory test or a battery of tests can predict the outcome in in vitro fertilization (IVF).One-hundred and sixty-one patients who underwent an IVF treatment were selected from a database of 4178 patients who had been examined for male infertility 3 months before or after IVF. Sperm concentration, motility, acrosin activity, acrosome reaction, sperm morphology, maternal age, number of transferred embryos, embryo score, fertilization rate and pregnancy rate were determined. In addition, logistic regression models to describe fertilization rate and pregnancy were developed. All the parameters in the models were dichotomized and intra-and interindividual variability of the parameters were assessed. Although the sperm parameters showed good correlations with IVF when correlated separately, the only essential parameter in the multivariate model was morphology. The enormous intra-and interindividual variability of the values was striking. In conclusion, our data indicate that the andrological status at the end of the respective treatment does not necessarily represent the status at the time of IVF. Despite a relatively low correlation coefficient in the logistic regression model, it appears that among the parameters tested, the most reliable parameter to predict fertilization is normal sperm morphology. (Reprod Med Biol 2005; 4: 7-30) Key words: assisted reproduction, high intra-and interindividual variability, multivariate approach, prediction of outcome of IVF, sperm functions.

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Age is a better predictor of pregnancy potential than basal follicle-stimulating hormone levels in women undergoing in vitro fertilization

Cited by 131 publications

References 20 publications

Antral follicle count in the prediction of poor ovarian response and pregnancy after in vitro fertilization: A meta-analysis and comparison with basal follicle-stimulating hormone level

Antral follicle count in the prediction of poor ovarian response and pregnancy after in vitro fertilization: A meta-analysis and comparison with basal follicle-stimulating hormone level

GnRH analogues: applications in assisted reproductive techniques

Sperm function and assisted reproduction technology

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