title: Age and follicular phase estradiol are better predictors of pregnancy outcome than luteinizing hormone in menotropin ovulation induction for anovulatory polycystic ovarian syndrome.
abstract: OBJECTIVE
  To examine the relationship of baseline and preovulatory serum E2, P, and LH levels and age with pregnancy outcome in polycystic ovarian syndrome (PCOS) patients undergoing hMG ovulation induction.
  
  
  METHODS
  Retrospective analysis of all available data over 2 years.
  
  
  METHODS
  Tertiary referral ovulation induction clinic.
  
  
  METHODS
  Forty-four anovulatory PCOS patients with 25 ovulatory nonconception and 50 conception cycles after hMG ovulation induction.
  
  
  METHODS
  Ovulation (midluteal serum P > 25 nmol/L [7.86 ng/mL]); pregnancy (serum beta-hCG > 30 mIU/mL 16 days after ovulating injection); pregnancy outcome: pregnancy termination < 20 weeks' or > or = 20 weeks' amenorrhea.
  
  
  RESULTS
  Of the endocrine parameters considered, none was significantly different in nonconceptive and conceptive ovulatory cycles. Miscarriage was associated with low basal serum E2: median value for pregnancies ending < 20 weeks, 105 pmol/L (28.6 pg/mL) and for > or = 20 weeks 150 pmol/L (40.9 pg/mL). It was also significantly associated with age. For patients > 29.5 years of age, (29.5 years, population mean age) a baseline E2 < or = 140 pmol/L (38.2 pg/mL) had sensitivity 92%, specificity 54%, positive predictive value 65%, and negative predictive value 87% for the prediction of miscarriage. The nature of the previous cycle, the day of the cycle on which therapy commenced, and a past history of miscarriage were not related either to pregnancy outcome or to basal serum E2.
authors.affiliation: Prince Henry's Institute of Medical Research, Melbourne, Victoria, Australia.
authors.forename: N
authors.initials: N
authors.lastname: McClure
authors.forename: J
authors.initials: J
authors.lastname: McDonald
authors.forename: G T
authors.initials: GT
authors.lastname: Kovacs
authors.forename: D L
authors.initials: DL
authors.lastname: Healy
authors.forename: P I
authors.initials: PI
authors.lastname: McCloud
authors.forename: B
authors.initials: B
authors.lastname: McQuinn
authors.forename: H G
authors.initials: HG
authors.lastname: Burger
mesh_terms: D000022:Abortion, Spontaneous / Q000097:blood*; D000328:Adult; D004958:Estradiol / Q000097:blood*; D005260:Female; D005498:Follicular Phase / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D008423:Maternal Age; D008596:Menotropins / Q000494:pharmacology*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology*; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone