Three successful pregnancies with in vitro fertilization embryo transfer over an eight year time span despite elevated basal serum follicle stimulating hormone levels. Case report.
OBJECTIVE
To demonstrate that elevated basal follicle stimulating hormone (FSH) does not necessarily signify poor quality eggs.


METHODS
In vitro fertilization-embryo transfer (IVF-ET) performed because of unexplained infertility and male factor related to low hypo-osmotic swelling test.


RESULTS
Three live pregnancies following lowering of elevated serum FSH with ethinyl estradiol followed by gonadotropin therapy. The patient had seven attempted oocyte retrievals and five led to ET. Despite markedly elevated basal serum FSH levels she achieved a delivered pregnancy rate of 42.8% per retrieval, 60% per transfer and an implantation rate of 27.2%/embryo transfer.


CONCLUSIONS
This study clearly shows that high serum FSH in a woman of younger reproductive age does not mean egg quality is poor. The case also shows that since ovulation induction was still possible eight years later that the paucity of eggs in younger women is more likely related to a previous catastrophic event that markedly diminished egg reserve but that egg atresia proceeds at the normal rate thereafter.
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J H
JH
The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ, USA.
Katsoff
B
B
D000328:Adult; D004624:Embryo Transfer; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female; D008423:Maternal Age; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome
D006062:Gonadotropins; D004997:Ethinyl Estradiol; D005640:Follicle Stimulating Hormone