Basal estradiol and follicle-stimulating hormone predict fecundity in women of advanced reproductive age undergoing ovulation induction therapy

Abstract

Objective: To determine the prognostic value of single basal E 2 and FSH levels as predictors of fecundity in women of advanced reproductive age who are undergoing ovulation induction with IUI therapy. Design: Prospective, observational. Setting: Fertility service of university medical center. Patient(s): Infertile couples in which the female partner was ⪰38 years old. Intervention(s): Single assessment of basal E 2 and FSH levels and ovulation induction with IUI. Main Outcome Measure(s): Cumulative and clinical pregnancy rates and live birth rates. Result(s): All live births occurred in patients with a basal E 2 ≤80 pg/mL (conversion factor to SI unit, 3.671), a basal FSH ≤ 13 mIU/mL (conversion factor to SI unit, 1.00), and a chronological age ≤42 years. In women 38 to 42 years of age, 10.3% had elevated basal E 2 (>80 pg/mL) in combination with normal basal FSH (≤13 mIU/mL), and no live births occurred in these couples. The cumulative live birth rate after four treatment cycles in women 38 to 42 years of age with both normal basal E 2(≤80 pg/mL) and FSH levels (≤13 mIU/mL) was 43.9%. Conclusion(s): Basal E 2 improves the ability to predict fertility potential compared with basal FSH and chronological age alone. Basal E 2, in combination with basal FSH and chronological age, has useful prognostic value in prospectively counseling patients of advanced reproductive age who are considering ovulation induction and IUI therapy.