Infertile women of advanced reproductive age. Variability of day 3 FSH and E2 levels.
OBJECTIVE
To evaluate the variability of basal (day 3) levels of follicle stimulating hormone (FSH) and estradiol (E2) in infertile women of advanced reproductive age.


METHODS
Retrospective analysis of day 3 FSH and E2 concentrations measured serially in patients of advanced reproductive age at a tertiary university fertility center.


RESULTS
Forty-seven infertile women > or = 38 years of age (range, 38-47) undergoing ovulation induction therapy had basal FSH and E2 levels measured on two or more cycles within a two-year periods. During the study period all live births occurred in patients with day 3 FSH values < or = 13 mIU/mL and E2 values < or = 80 pg/mL, and these values were used as normative cutoffs for favorable ovarian reserve. Eleven of 38 women (28.9%) demonstrated a shift in basal values of FSH and/or E2 from the normal to the abnormal range in a subsequent cycle. Of these 11 women, 10 (90.9%) demonstrated a shift of only one hormone (FSH, n = 6) or (E2, n = 4) from the normal to the elevated range. One of 47 women (2.1%) had a shift of both basal FSH and E2 from the normal to the elevated range in a subsequent cycle. All patients who presented with or later developed an elevated day 3 level of FSH and/or E2 had persistent elevations of one or both hormones in all subsequent measurements.


CONCLUSIONS
Day 3 FSH and/or E2 concentrations shifted from the normal to the abnormal range in 28.9% of an infertile patient population of advanced reproductive age screened serially within a two-year period. We hypothesize that serial assessment of basal FSH in combination with E2 will improve the ability to detect diminished ovarian reserve in infertile women of advanced reproductive age.
Buyalos
R P
RP
Department of Obstetrics and Gynecology, University of California at Los Angeles School of Medicine, USA.
Ghosh
K
K
Daneshmand
S T
ST
D000328:Adult; D000367:Age Factors; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000378:metabolism*; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
D004958:Estradiol; D005640:Follicle Stimulating Hormone