title: Establishing institutional critical values of follicle-stimulating hormone levels to predict in vitro fertilization success.
abstract: Elevated follicle-stimulating hormone (FSH) levels during the early follicular phase or in response to the clomiphene citrate challenge test indicate diminished ovarian reserve and poor reproductive potential. We performed a retrospective analysis of 413 infertile women, 23 to 40 years of age, who underwent 523 cycles of in vitro fertilization (IVF) to identify the critical FSH values that would predict a poor likelihood of success in our military IVF program. Each woman underwent a clomiphene citrate challenge test within 1 year of each IVF cycle. The overall live birth and implantation rates were 43% and 24%, respectively. The critical values for day 3 and day 10 FSH levels were 14.1 and 16.9 mIU/mL, respectively, with a 0% live birth rate and a 5% implantation rate above these levels. There were no differences in the live birth/implantation rates when stratified for FSH levels below the critical values. Medical centers offering IVF should determine their critical FSH values, to help identify patients unlikely to benefit from IVF and to ensure appropriate allocation of resources and realistic expectations for infertile couples.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wilford Hall Medical Center, San Antonio Uniformed Services Health Education Consortium, Lackland Air Force Base, TX 78236, USA.
authors.forename: Laura Lee Rihl
authors.initials: LL
authors.lastname: Joiner
authors.forename: Randal D
authors.initials: RD
authors.lastname: Robinson
authors.forename: Wright
authors.initials: W
authors.lastname: Bates
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Propst
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005307:Fertilization in Vitro / Q000592:standards*; D005640:Follicle Stimulating Hormone / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000628:therapy; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005640:Follicle Stimulating Hormone