Predicting in vitro fertilization live birth using stimulation day 6 estradiol, age, and follicle-stimulating hormone

Srouji, Serene S.; Mark, Alice; Levine, Zalman; Betensky, Rebecca A.; Hornstein, Mark D.; Ginsburg, Elizabeth S.

doi:10.1016/j.fertnstert.2005.02.042

Cited by 16 publications

(14 citation statements)

References 8 publications

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“…For example, our findings indicate that a low day 3 FSH (<4.6 mIU/mL) confer high pregnancy rates in a very small and specific subset of patients (see Condition E in Table 2), and offer new perspectives on this controversial entity. While abnormally high levels of day 3 FSH have been associated with ovarian aging, poor ovarian response in IVF, and poor IVF cycle outcomes, many studies have cautioned against its use in clinical management due to its low sensitivity, especially in women under 40 [42], [43], [44], [45]. However, the clinical utility of this test may be improved by determining appropriate thresholds and conditions [46].…”

Section: Discussionmentioning

confidence: 99%

Defining Human Embryo Phenotypes by Cohort-Specific Prognostic Factors

et al. 2008

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BackgroundHundreds of thousands of human embryos are cultured yearly at in vitro fertilization (IVF) centers worldwide, yet the vast majority fail to develop in culture or following transfer to the uterus. However, human embryo phenotypes have not been formally defined, and current criteria for embryo transfer largely focus on characteristics of individual embryos. We hypothesized that embryo cohort-specific variables describing sibling embryos as a group may predict developmental competence as measured by IVF cycle outcomes and serve to define human embryo phenotypes.Methodology/Principal FindingsWe retrieved data for all 1117 IVF cycles performed in 2005 at Stanford University Medical Center, and further analyzed clinical data from the 665 fresh IVF, non-donor cycles and their associated 4144 embryos. Thirty variables representing patient characteristics, clinical diagnoses, treatment protocol, and embryo parameters were analyzed in an unbiased manner by regression tree models, based on dichotomous pregnancy outcomes defined by positive serum ß-human chorionic gonadotropin (ß-hCG). IVF cycle outcomes were most accurately predicted at ∼70% by four non-redundant, embryo cohort-specific variables that, remarkably, were more informative than any measures of individual, transferred embryos: Total number of embryos, number of 8-cell embryos, rate (percentage) of cleavage arrest in the cohort and day 3 follicle stimulating hormone (FSH) level. While three of these variables captured the effects of other significant variables, only the rate of cleavage arrest was independent of any known variables.Conclusions/SignificanceOur findings support defining human embryo phenotypes by non-redundant, prognostic variables that are specific to sibling embryos in a cohort.

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Section: Discussionmentioning

confidence: 99%

Defining Human Embryo Phenotypes by Cohort-Specific Prognostic Factors

et al. 2008

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“…Hence, the ability to predict an individual’s responses to COH would constitute a major advance in patient care. Although many hormonal and clinical parameters (such as baseline FSH [2], oestradiol [3], inhibin B [4] and anti-Mullerian hormone (AMH) levels [5], patient age [6] and the antral follicle count [7]) have been used to optimize COH, none of these markers have significant predictive value when considered alone [8], [9], However, predictive performance levels can be improved by considering combinations of these parameters [10].…”

Section: Introductionmentioning

confidence: 99%

Genetic Polymorphisms Influence the Ovarian Response to rFSH Stimulation in Patients Undergoing In Vitro Fertilization Programs with ICSI

et al. 2012

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IntroductionObtaining an adequate number of high-quality oocytes is a major challenge in controlled ovarian hyperstimulation (COH). To date, a range of hormonal and clinical parameters have been used to optimize COH but none have significant predictive value. This variability could be due to the genetic predispositions of single-nucleotide polymorphisms (SNPs). Here, we assessed the individual and combined impacts of thirteen SNPs that reportedly influence the outcome of in vitro fertilisation (IVF) on the ovarian response to rFSH stimulation for patients undergoing intracytoplasmic sperm injection program (ICSI).ResultsUnivariate analysis revealed that only FSHR, ESR2 and p53 SNPs influenced the number of mature oocytes. The association was statistically significant for FSHR (p=0.0047) and ESR2 (0.0017) in the overall study population and for FSHR (p=0.0009) and p53 (p=0.0048) in subgroup that was more homogeneous in terms of clinical variables. After Bonferroni correction and a multivariate analysis, only the differences for FSHR and ESR2 polymorphisms were still statistically significant. In a multilocus analysis, only the FSHR and AMH SNP combination significantly influenced oocyte numbers in both population (p<0.01).DiscussionWe confirmed the impact of FSHR and ESR2 polymorphisms on the IVF outcome. Furthermore, we showed for the first time that a p53 polymorphism (which is already known to impact embryo implantation) could influence the ovarian response. However, given that this result lost its statistical significance after multivariate analysis, more data are needed to draw firm conclusions. Only the FSHR and AMH polymorphism combination appears to influence mature oocyte numbers but this finding also needs to be confirmed.Materials and MethodsA 13 gene polymorphisms: FSHR(Asn680Ser), p53(Arg72Pro), AMH(Ile49Ser), ESR2(+1730G>A), ESR1(−397T>C), BMP15(−9C>G), MTHFR1(677C>T), MTHFR2(1298A>C), HLA-G(−725C>G), VEGF(+405G>C), TNFα(−308A>G), AMHR(−482 A>G), PAI-1 (4 G/5 G), multiplex PCR assay was designed to genotype women undergoing ICSI program. We analyzed the overall study population (n=427) and a subgroup with homogeneous characteristics (n=112).

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“…The most important oestrogen is estradiol (E) [8], the serum level of which in combination with that of FSH, and age is predictive of pregnancy outcome after IVF treatment [10]. …”

Section: Introductionmentioning

confidence: 99%

Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility

Murto

Bjuresten

Landgren

et al. 2013

Reprod Biol Endocrinol

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BackgroundInfertile women might get pregnant sometime after fertility treatment, but today, there is no prediction model on who will eventually have children. The objective of the present study was to characterize hormone levels in an arbitrary menstrual cycle in women with unexplained infertility and male infertility, and to determine the predictive value for long-term possibility of live birth.MethodsIn this cross-sectional study, with 71 infertile women with diagnosis unexplained infertility and male infertility, blood samples were obtained during the proliferative and secretory phases of an arbitrary menstrual cycle. Serum concentrations of FSH, LH, AMH, inhibin B, estradiol, progesterone, PRL and TSH were determined. The predictive value of ovulation and hormonal analysis was determined by identifying the proportion of women with at least one live birth. Mann Whitney U test, chi2 test and Spearman’s correlation were used for statistical analysis. A value of p < 0.05 was considered statistically significant.ResultsThere were no differences in hormone values and live birth rates between women with unexplained infertility and male infertility. The best sole predictors of live birth were age of the women, followed by ovulatory cycle, defined as serum progesterone concentration of greater than or equal to 32 nmol/L, and a serum TSH concentration of less than or equal to 2.5 mIU/L. Combining the age with the ovulatory cycle and serum TSH less than or equal to 2.5 mIU/L or serum AMH greater than or equal to 10 pmol/L the predictive value was close to 90%.ConclusionsAge in combination with the presence of an ovulatory cycle and serum TSH or serum AMH is predictive for long-term live birth. The advantage of serum AMH compared with serum TSH is the very little variation throughout the menstrual cycle, which makes it a useful tool in infertility diagnosis.

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Predicting in vitro fertilization live birth using stimulation day 6 estradiol, age, and follicle-stimulating hormone

Cited by 16 publications

References 8 publications

Defining Human Embryo Phenotypes by Cohort-Specific Prognostic Factors

Defining Human Embryo Phenotypes by Cohort-Specific Prognostic Factors

Genetic Polymorphisms Influence the Ovarian Response to rFSH Stimulation in Patients Undergoing In Vitro Fertilization Programs with ICSI

Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility

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