title: Moderately elevated levels of basal follicle-stimulating hormone in young patients predict low ovarian response, but should not be used to disqualify patients from attempting in vitro fertilization.
abstract: OBJECTIVE
  To evaluate and compare IVF outcomes of patients within different age categories who had a normal basal FSH level with outcomes of patients with an elevated day 3 FSH level.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Large, private IVF center.
  
  
  METHODS
  We analyzed 2,708 patients. Of these, 2,477 had normal basal FSH levels, and 231 had elevated basal FSH levels (> or =13.03 IU/L). Patients were segregated into various age groups.
  
  
  METHODS
  Follow-up.
  
  
  METHODS
  Outcomes of IVF overall, including cancellation rates, oocyte yield, and fertilization, implantation, and clinical pregnancy rates (PRs).
  
  
  RESULTS
  Cancellation rates were significantly higher in patients with elevated day 3 FSH levels compared with patients with normal FSH levels in all age groups. A significantly lower oocyte yield was observed in patients with elevated basal FSH. Fertilization rates were not affected by FSH levels. A significant decrease in the number of embryos available for transfer in patients > or =38 with an elevated day 3 FSH level was found. Implantation and clinical PRs were lower in patients >40 years of age who had an elevated day 3 FSH level when compared to same age patients with a normal day 3 FSH level. Loss rates were not significantly different.
  
  
  CONCLUSIONS
  Young women with an elevated basal FSH level should be counseled differently than older women, and should be given adequate counseling and granted the opportunity to undergo an IVF cycle.
authors.affiliation: Department of Obstetrics and Gynecology, Mount Sinai School of Medicine, New York, New York, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Luna
authors.forename: Lawrence
authors.initials: L
authors.lastname: Grunfeld
authors.forename: Tanmoy
authors.initials: T
authors.lastname: Mukherjee
authors.forename: Benjamin
authors.initials: B
authors.lastname: Sandler
authors.forename: Alan Barry
authors.initials: AB
authors.lastname: Copperman
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D010053:Ovary / Q000502:physiology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D005640:Follicle Stimulating Hormone