title: Discrimination between chronological and ovarian age in infertile women aged 35 years and older: predicting pregnancy using basal follicle stimulating hormone, age and number of ovulation induction/intra-uterine insemination cycles.
abstract: A marked decline in fertility rates has been demonstrated in women > 35 years of age. We have previously demonstrated the importance of basal follicle stimulating hormone (FSH) concentrations plus chronological age to predict pregnancies in women aged >/=40 years undergoing ovulation induction therapy. The purpose of the current study was to extend our previous study and determine the impact of age, basal FSH concentrations and ovulation induction/inter-uterine insemination (IUI) treatment cycles on pregnancy rates in infertile women age >/=35 years. This prospective observational study was performed at a tertiary university fertility centre. Assessments of basal hormonal status and ovulation induction protocols were performed. The main outcome measured was clinical pregnancies. A total of 770 treatment cycles in 179 women aged >/=35 years were analysed. The impact of basal FSH concentrations on treatment outcomes could be bifurcated into a favourable group (FSH </=23 mIU/ml) and a poor prognosis group (FSH >/= mIU/ml). A multivariate logistic regression model was generated which accurately predicted pregnancies. There was a high degree of correlation between predicted pregnancies and observed pregnancies (r = 0.86). We conclude that age, number of treatment cycles and the interaction term basal FSH x age are useful and significant predictors of pregnancies in patients aged >/=35 years undergoing ovulation induction/IUI therapy.
authors.affiliation: Department of Obstetrics and Gynecology, University of California School of Medicine, (UCLA), Los Angeles, CA 90024, USA.
authors.forename: P C
authors.initials: PC
authors.lastname: Magarelli
authors.forename: A C
authors.initials: AC
authors.lastname: Pearlstone
authors.forename: R P
authors.initials: RP
authors.lastname: Buyalos
mesh_terms: D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology*; D007315:Insemination, Artificial; D008423:Maternal Age; D008875:Middle Aged; D015999:Multivariate Analysis; D010062:Ovulation Induction; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D005640:Follicle Stimulating Hormone