Follicle-stimulating hormone and estradiol levels independently predict the success of assisted reproductive technology treatment.
OBJECTIVE
To evaluate the relationship between early follicular phase levels of FSH and E(2) and outcomes of therapy with assisted reproductive technologies (ART).


METHODS
Retrospective cohort study.


METHODS
ART centers in the United States.


METHODS
Women receiving 19,682 ART procedures performed in 135 clinics.


METHODS
None.


METHODS
Rates of clinical pregnancy, live birth delivery, and high ovarian response (>/=10 oocytes retrieved after stimulation).


RESULTS
The ratio of each FSH or E(2) value to the respective upper limit of normal value for the clinic was computed. Within each age group, rates of pregnancy, live birth, and high ovarian response decreased linearly as FSH levels increased. For example, among women 35 years of age and younger, pregnancy rates (PR) ranged from 41.1% (FSH ratio 0-0.5) to 18.5% (FSH ratio >2.0). The three outcomes exhibited a similar downward trend as E(2) ratios increased. When both hormone ratios were elevated, outcomes were least favorable. These relationships remained statistically significant after we adjusted for diagnosis, number of embryos transferred, previous births, previous ART therapy, and use of GIFT, zygote intrafallopian transfer (ZIFT), intracytoplasmic sperm injection (ICSI), or assisted hatching.


CONCLUSIONS
The FSH and E(2) ratios predict ART success independent of age and other clinical prognostic factors.
Department of Obstetrics and Gynecology, University of Kansas School of Medicine-Wichita, 67214, USA. lfrazier@kumc.edu
Linda M
LM
Frazier
David A
DA
Grainger
Laura A
LA
Schieve
James P
JP
Toner
D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D005498:Follicular Phase / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009865:Oocytes / Q000502:physiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies
D004958:Estradiol; D005640:Follicle Stimulating Hormone