Future in vitro fertilization pregnancy potential of women with variably elevated day 3 follicle-stimulating hormone levels.
OBJECTIVE
To determine the IVF-ET pregnancy potential of women with variably elevated day 3 FSH.


METHODS
Cohort evaluation of 1,868 consecutive IVF-ET cycles January 1991 to December 1994.


METHODS
University hospital infertility unit.


METHODS
Four cohorts of couples were defined based on day 3 FSH determinations with an arbitrary threshold of 20 mIU/mL, only > or = 20 mIU/mL, always < 20 mIU/mL, current < 20 mIU/mL but one previous > or = 20 mIU/mL, and current < 20 mIU/mL but two or more previous > or = 20 mIU/mL (conversion factor to SI unit, 1.00).


METHODS
In vitro fertilization-embryo transfer.


METHODS
Fetal heart activity on luteal day 40 transvaginal ultrasound.


RESULTS
No pregnancies occurred in 53 cycles with day 3 FSH only > or = 20 mIU/mL. In 1,750 women whose day 3 FSH levels were always < 20 mIU/mL, the pregnancy rate (PR) per cycle was 16.5%. In 54 cycles in which day 3 FSH was > or = 20 one time only, but < 20 mIU/mL during the treatment cycle, the PR was 5.6%. In 11 cycles where two or more previous FSH determinations were > or = 20 mIU/mL but with a current day 3 FSH < 20 mIU/mL, no pregnancies occurred.


CONCLUSIONS
Our data leads us to the conclusion that day 3 FSH determination precede every IVF cycle and that cycles with FSH > or = 20 mIU/mL be canceled. It also suggests that women with two previous elevations of day 3 FSH be discouraged from future IVF cycles. The 5.6% pregnancy per cycle with one previously elevated FSH warrants extreme pessimism in discussion of further cycles.
Martin
J S
JS
Department of Gynaecology and Reproductive Medicine, University Hospital, University of Western Ontario, London, Canada.
Nisker
J A
JA
Tummon
I S
IS
Daniel
S A
SA
Auckland
J L
JL
Feyles
V
V
D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D015331:Cohort Studies; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007246:Infertility / Q000628:therapy*; D008297:Male; D011247:Pregnancy
D006063:Chorionic Gonadotropin; D004958:Estradiol; D005640:Follicle Stimulating Hormone