Age and follicular phase estradiol are better predictors of pregnancy outcome than luteinizing hormone in menotropin ovulation induction for anovulatory polycystic ovarian syndrome.
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.
McClure
N
N
Prince Henry's Institute of Medical Research, Melbourne, Victoria, Australia.
McDonald
J
J
Kovacs
G T
GT
Healy
D L
DL
McCloud
P I
PI
McQuinn
B
B
Burger
H G
HG
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
D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone