title: 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.
abstract: 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.
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Gürgan
authors.forename: B
authors.initials: B
authors.lastname: Urman
authors.forename: H
authors.initials: H
authors.lastname: Yarali
authors.forename: H E
authors.initials: HE
authors.lastname: Duran
mesh_terms: 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
chemical_list: D006063:Chorionic Gonadotropin; D005640:Follicle Stimulating Hormone; D002064:Buserelin