title: Future in vitro fertilization pregnancy potential of women with variably elevated day 3 follicle-stimulating hormone levels.
abstract: 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.
authors.affiliation: Department of Gynaecology and Reproductive Medicine, University Hospital, University of Western Ontario, London, Canada.
authors.forename: J S
authors.initials: JS
authors.lastname: Martin
authors.forename: J A
authors.initials: JA
authors.lastname: Nisker
authors.forename: I S
authors.initials: IS
authors.lastname: Tummon
authors.forename: S A
authors.initials: SA
authors.lastname: Daniel
authors.forename: J L
authors.initials: JL
authors.lastname: Auckland
authors.forename: V
authors.initials: V
authors.lastname: Feyles
mesh_terms: 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
chemical_list: D006063:Chorionic Gonadotropin; D004958:Estradiol; D005640:Follicle Stimulating Hormone