Predictive value of age-specific FSH levels for IVF-ET outcome in women with normal ovarian function

Abstract

BackgroundMost of infertile women with normal follicle stimulating hormone (FSH) levels and antral follicle count (AFC) at day 2–3 of the period, but poor IVF outcomes may occur when use of routine controlled ovarian stimulation. This paper is to evaluate the predictive value of age-specific FSH levels for IVF-ET outcomes in women with normal ovarian function.MethodsA total of 1287 women undergoing their first IVF cycles were enrolled in this retrospective study. The FSH levels and AFC of all of the women were within normal ranges (FSH ≤ 12 IU/L;AFC ≥ 5). The patients were grouped by age (younger: < 33 years, medium-aged:33–37years and older:38–41years), and within each age group, the patients were subdivided by the upper limit of the 95 % confidence interval (CI) for mean FSH levels. Patients with FSH levels equal to or greater than the upper 95 % CI of FSH in each age group were included into a premature ovarian aging (POA) subgroup (younger:FSH ≥ 7.84, medium-aged: ≥8.12 and older: FSH ≥ 8.47),the remaining patients in each age group were included into a control subgroup. The outcomes of IVF-ET were compared between the POA subgroup and the control subgroup in each age group.ResultsIn each age group, the total dose of gonadotropin(Gn) in the POA subgroups were significantly higher than those of the corresponding control subgroups. In the younger and medium-aged groups, women in the POA subgroups had significantly lower oocyte yields, frozen embryos, and higher rates of poor ovarian response(POR) than those in the corresponding control subgroups. When controlling for age, BMI and AFC, the multiple logistic regression analysis indicated the following: In each age group, the total dose of Gn was significantly correlated with POA; the oocyte yield was significantly related to POA only in the younger group; and in the whole age groups, the incidence of POR in the POA group was 2.719 times greater than in the control group (OR = 2.719, 95 % CI [1.598–4.625], P < 0.001).ConclusionBasal FSH levels combined with age (age-specific FSH levels) can be used as a more accurate marker for the ovarian response in women with normal ovarian reserves undergoing IVF-ET, particularly in women ≤37 years old.

Impact of Age on Hormonal Profiles of Sub-Fertile Women Attending Fertility Clinic in Umuahia, Abia State, South Eastern Nigeria

“…This also implies that maturation of eggs and ovulation may not be possible in an advanced age. This is in agreement with the study of Sowers et al [25], and Fang et al [26] that significant increase in FSH levels with increasing age is a result of disturbances in the ovarian function which relates directly with infertility. The implication of elevated LH values points to cycle inconsistency, which hinders folliculogenesis and normal function of the ovaries, an important role played by LH, and this will nonetheless, lead to infertility and increased occurrence of miscarriages [27] [28].…”

Antral follicle count is reduced in the presence of endometriosis: a systematic review and meta-analysis

“…In addition, concerns have recently been raised about possible methodological issues with the use of AMH (Ledger, 2014;. Moreover, it should be emphasized that several studies investigating the ovarian reserve in endometriosis, following endometrioma surgery or in the IVF technique, have made changes in AFC the primary endpoint (Benaglia et al, 2015;Fang et al, 2015;Nicolaus et al, 2019). Overall, there are reasons to believe that AFC should be regarded as an accurate marker for evaluating the impact of endometriosis on ovarian reserve.…”

The Effect of Age Specific FSH Levels on In Vitro Fertilization-Intracytoplasmic Sperm Injection/Embryo Transfer Outcomes in Women with Normal Ovarian Function

“…Fang ve ark., normal ovaryan fonksiyona sahip 1.287 hastanın ilk IVF siklusuna ait verilerini değerlendirerek yaptıkları retrospektif çalışmada, total gonadotropin dozunun tüm yaş gruplarında EOY olan hastalarda kontrol grubuna göre istatistiksel olarak anlamlı farklı olduğunu, elde edilen oosit sayısı ve azalmış ovaryan yanıt oranlarının ise genç ve orta yaş grubunda istatistiksel olarak anlamlı farklı olduğunu bildirmişlerdir. 20 Bu çalışmada ise total gonadotropin dozu genç ve orta yaş grubunda EOY olan hastalarda kontrol grubuna göre istatistiksel olarak anlamlı fazla saptanırken, ileri yaş grubunda hastalar arasında istatistiksel olarak anlamlı fark saptanmamıştır.…”