title: Women older than 40 years of age and those with elevated follicle-stimulating hormone levels differ in poor response rate and embryo quality in in vitro fertilization.
abstract: OBJECTIVE
  To investigate whether IVF outcome of patients older than 40 years of age with basal FSH levels less than 15 IU/L differs from that in patients 40 years of age or younger with basal FSH levels of 15 IU/L or greater.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Tertiary academic fertility center.
  
  
  METHODS
  Women 41 years of age or older with basal FSH levels less than 15 IU/L (n = 50), and women 40 years of age or younger with elevated basal FSH levels (n = 36) undergoing their first IVF cycle.
  
  
  METHODS
  IVF treatment using a long suppression protocol with recombinant FSH at a fixed starting dose of 150 IU/L.
  
  
  METHODS
  Ovarian response, ongoing pregnancy rates, and implantation rates.
  
  
  RESULTS
  The high FSH group experienced more cycle cancellations due to absent follicular growth than did the high age group (31% vs. 8%). However, the high FSH group had better implantation rates per embryo (34% vs. 11%), higher ongoing rates per ET (40% vs.13%), and higher ongoing pregnancy rates per cycle (25% vs. 10%). In both groups, poor responders had lower pregnancy rates.
  
  
  CONCLUSIONS
  The outcome of IVF differs between patients older than 40 years of age with normal FSH levels and relatively young patients with elevated FSH levels. This finding may have implications for the management of these patients.
authors.affiliation: Department of Reproductive Medicine, Division of Obstetrics, Neonatology and Gynecology, University Medical Center Utrecht, The Netherlands. i.vanrooij@azu.nl
authors.forename: Ilse A J
authors.initials: IA
authors.lastname: van Rooij
authors.forename: László F J M M
authors.initials: LF
authors.lastname: Bancsi
authors.forename: Frank J M
authors.initials: FJ
authors.lastname: Broekmans
authors.forename: Caspar W N
authors.initials: CW
authors.lastname: Looman
authors.forename: J Dik F
authors.initials: JD
authors.lastname: Habbema
authors.forename: Egbert R
authors.initials: ER
authors.lastname: te Velde
mesh_terms: D000328:Adult; D000375:Aging; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D006080:Ovarian Follicle / Q000033:anatomy & histology; D010062:Ovulation Induction; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D005640:Follicle Stimulating Hormone