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.
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.
van Rooij
Ilse A J
IA
Department of Reproductive Medicine, Division of Obstetrics, Neonatology and Gynecology, University Medical Center Utrecht, The Netherlands. i.vanrooij@azu.nl
Bancsi
László F J M M
LF
Broekmans
Frank J M
FJ
Looman
Caspar W N
CW
Habbema
J Dik F
JD
te Velde
Egbert R
ER
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
D005640:Follicle Stimulating Hormone