Prediction of response to controlled ovarian hyperstimulation: a comparison of basal and clomiphene citrate-stimulated follicle-stimulating hormone levels.
OBJECTIVE
To test the ovarian reserve in a high-risk population before controlled ovarian hyperstimulation for in vitro fertilization (IVF).


METHODS
A prospective study comparing the outcome of a clomiphene citrate (CC) challenge test to the outcome of subsequent IVF cycles.


METHODS
Unit for assisted reproductive technology in a university hospital.


METHODS
Ninety-one infertile women with an age of 35 years or more, who had previous ovarian surgery or who had been diagnosed with ovarian endometriosis.


METHODS
Relate follicle-stimulating hormone (FSH) levels before and after CC to frequency of cancellation of an IVF cycle because of a poor follicular response.


RESULTS
Twenty-one patients had elevated basal levels of FSH. Thirty-seven patients, including 20 with high basal levels, showed an excessive FSH response to CC with an FSH level after CC above the 95% confidence limit. Clomiphene citrate-stimulated FSH levels correlated better than basal levels with response to controlled ovarian hyperstimulation. An excessive FSH response to CC predicted a poor response outcome of subsequent controlled ovarian hyperstimulation for IVF with 85% accuracy.


CONCLUSIONS
Follicle-stimulating hormone response to CC predicts subsequent follicular response to controlled ovarian hyperstimulation.
Tanbo
T
T
Department of Obstetrics and Gynecology, National Hospital, University of Oslo, Norway.
Dale
P O
PO
Lunde
O
O
Norman
N
N
Abyholm
T
T
D000328:Adult; D002996:Clomiphene; D004715:Endometriosis / Q000503:physiopathology; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle; D010053:Ovary / Q000187:drug effects / Q000503:physiopathology*; D011336:Probability; D011374:Progesterone / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies
D002996:Clomiphene; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone