Predicting poor ovarian response in IVF: use of repeat basal FSH measurement.
OBJECTIVE
To evaluate the additional value of a second basal follicle stimulating hormone (FSH) level, in a different cycle, in the prediction of poor response in in vitro fertilization (IVF) by a single basal FSH measurement.


METHODS
In 120 patients, basal FSH was determined prospectively in 2 spontaneous cycles. The additional value of a second basal FSH measurement in the prediction of poor ovarian response in IVF by a single basal FSH measurement was studied.


RESULTS
Due to chance variation, the predictive accuracy of a poor response of the first and second basal FSH measurement differed (ROC(AUC) .84 and .74, respectively). In a multivariate analysis, the higher of the first and second basal FSH levels provided the best predictive accuracy (ROC(AUC) .85). In terms of clinical relevance, however, a predictive model with the highest basal FSH level provided only slightly more correct predictions of poor and normal ovarian response than did models based solely on a single basal FSH measurement.


CONCLUSIONS
Using basal FSH, a substantial number of patients will be misdiagnosed with regard to their ovarian response potential in IVF, even if repeat measurement is performed.
Bancsi
László F J M M
LF
Division of Obstetrics, Neonatology and Gynecology, Department of Reproductive Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. lbancsi@azu.nl
Broekmans
Frank J M
FJ
Looman
Caspar W N
CW
Habbema
J Dik F
JD
te Velde
Egbert R
ER
D015415:Biomarkers / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D010053:Ovary / Q000502:physiology*; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D015415:Biomarkers; D005640:Follicle Stimulating Hormone