Follicle-stimulating hormone levels on cycle day 3 to predict ovarian response in women undergoing controlled ovarian hyperstimulation for in vitro fertilization using a flare-up protocol.
OBJECTIVE
To determine whether cycle day 3 serum FSH levels predict poor ovarian response and cycle cancellation in women undergoing controlled ovarian hyperstimulation (COH) for IVF.


METHODS
Prospective case series.


METHODS
University hospital IVF program.


METHODS
The study includes outcomes of 637 initial cycles of IVF.


METHODS
Controlled ovarian hyperstimulation was undertaken with a short, flare-up GnRH agonist and hMG protocol. The relation of cycle day 3 FSH levels with various cycle characteristics and outcomes was determined.


METHODS
The accuracy of cycle day 3 FSH levels in predicting poor ovarian response and cycle cancellation was evaluated. Receiver operating characteristic curves were constructed to determine the optimum cutoff value for the cycle day 3 serum FSH level that best predicted poor ovarian response and cycle cancellation.


RESULTS
A cycle day 3 serum FSH level > or = 13 mIU/mL (conversion factor to SI unit, 1.00) was associated with a high likelihood of poor ovarian response and cycle cancellation. The sensitivity, specificity, and positive likelihood ratio of an FSH level of 13 mIU/mL in predicting cycle cancellation were 52%, 91%, and 6.04, respectively.


CONCLUSIONS
Cycle day 3 FSH screening appears to be a fairly accurate predictor of poor ovarian response and cycle cancellation in women undergoing COH using a short, flare-up GnRH agonist and hMG protocol.
Gürgan
T
T
Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.
Urman
B
B
Yarali
H
H
Duran
H E
HE
D000328:Adult; D002064:Buserelin / Q000494:pharmacology; D006063:Chorionic Gonadotropin / Q000494:pharmacology; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D008297:Male; D008597:Menstrual Cycle; D010053:Ovary / Q000187:drug effects*; D011446:Prospective Studies
D006063:Chorionic Gonadotropin; D005640:Follicle Stimulating Hormone; D002064:Buserelin