[Basal fsh level is only predictive of the quantitative aspect of the ovarian response].
BACKGROUND
Determination FSH and LH at day 3 of the menstrual cycle predicts the response to stimulation.


OBJECTIVE
To evaluate the value of FSH and LH measurements compared with women's age in predicting qualitative and quantitative ovarian response to gonadotrophin stimulation.


METHODS
305 patients underwent at least one intra cytoplasmic sperm injection (ICSI) cycle. The levels of FSH and LH at day 3 were determined in an earlier cycle. A good quantitative ovarian response was defined as ³3 oocytes retrieved and 3 embryos obtained. A good qualitative ovarian response was defined as a percentage of mature oocytes ³75% and immature ones²15% of the total number of oocytes retrieved with at least one top quality embryo obtained.


RESULTS
Receiver operating characteristic (ROC) curves were generated for FSH, LH and female age. FSH is better than female age in predicting the number of oocytes retrieved (respectively ROCAUC=0.77, p=10-3 versus ROCAUC=0.73, p=10-3) and the number of embryos obtained (ROCAUC=0.69, p=10-3 versus ROCAUC=0.66, p=10-3). LH is non predictive. None of the three tested parameters was predictive of the fertilization and pregnancy rates. An FSH cutoff was calculated and a value of 7.8mUI/ml is associated with a sensitivity of 73% and a specificity of 70% for the prediction of ovarian response to controlled stimulation.


CONCLUSIONS
Basal FSH level predicts good quantitative rather than qualitative response. LH is non predictive. FSH and LH do not predict pregnancy rate. Patients having high FSH levels should not be excluded from IVF/ICSI treatment.
Faculte de medecine de Tunis, Universite de Tunis, El Manar, Tunisie.
Selima
S
Fourati
Ghaya
G
Merdassi
Mohamed
M
Khrouf
Hanene
H
Elloumi
Anis
A
Fadhlaoui
Imen
I
Brahmi
Nadia
N
Hammami
Sajiaa
S
Ben Slima
Mounir
M
Ben Meftah
Fethi
F
Zhioua
Amel
A
Zhioua
D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D010053:Ovary / Q000502:physiology*; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic
D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone