Basal estradiol and follicle-stimulating hormone predict fecundity in women of advanced reproductive age undergoing ovulation induction therapy.
OBJECTIVE
To determine the prognostic value of single basal E2 and FSH levels as predictors of fecundity in women of advanced reproductive age who are undergoing ovulation induction with IUI therapy.


METHODS
Prospective, observational.


METHODS
Fertility service of university medical center.


METHODS
Infertile couples in which the female partner was > or = 38 years old.


METHODS
Single assessment of basal E2 and FSH levels and ovulation induction with IUI.


METHODS
Cumulative and clinical pregnancy rates and live birth rates.


RESULTS
All live births occurred in patients with a basal E2 < or = 80 pg/mL (conversion factor to SI unit, 3.671), a basal FSH < or = 13 mIU/mL (conversion factor to SI unit, 1.00), and a chronological age < or = 42 years. In women 38 to 42 years of age, 10.3% had elevated basal E2 (> 80 pg/mL) in combination with normal basal FSH (< or = 13 mIU/mL), and no live births occurred in these couples. The cumulative live birth rate after four treatment cycles in women 38 to 42 years of age with both normal basal E2 (< or = 80 pg/mL) and FSH levels (< or = 13 mIU/mL) was 43.9%.


CONCLUSIONS
Basal E2 improves the ability to predict fertility potential compared with basal FSH and chronological age alone. Basal E2, in combination with basal FSH and chronological age, has useful prognostic value in prospectively counseling patients of advanced reproductive age who are considering ovulation induction and IUI therapy.
Buyalos
R P
RP
Department of Obstetrics and Gynecology, University of California, Los Angeles School of Medicine, USA.
Daneshmand
S
S
Brzechffa
P R
PR
D000328:Adult; D000375:Aging / Q000502:physiology*; D004958:Estradiol / Q000097:blood*; D005260:Female; D005298:Fertility / Q000502:physiology*; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007246:Infertility / Q000628:therapy; D007317:Insemination, Artificial, Homologous; D008297:Male; D008875:Middle Aged; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012016:Reference Values
D004958:Estradiol; D005640:Follicle Stimulating Hormone