Can Elevated Levels of Basal Follicle Stimulating Hormone Predict a Decrease in Fertility in Young Women Undergoing ART Cycles?

Abstract

Background: The determination of ovarian reserve is often measured in normal cycling women through day 3 basal FSH. This determination will help to choose patients who are eligible for starting assisted reproductive technique (ART) cycles. Female age and basal FSH level are independently associated with IVF outcome. Objective:This study aims’ at evaluating the impact of basal FSH level associated with female age on IVF outcome. Methods: A retrospective study that included 367 patients undergoing ICSI cycles. Basal FSH levels were measured using the same immunoenzymatic method for all patients. The age of women was checked before they were undergoing pituitary desensitization. Patients were divided into 4 groups according to their age and basal FSH levels. Then its correlation with IVF outcome was evaluated. Results:The increase of FSH levels was associated significantly with reduced oocytes retrieved, and embryos obtained in young women. Nevertheless, there was no significant difference in terms of fertilization or pregnancy rate. Cancellation rates were significantly higher among patients with high day 3 FSH levels compared to patients having normal FSH levels in all age groups. Loss rates were affected by FSH levels among patients < 38 years old. However, they were significantly higher in older patients having elevated day 3 FSH levels. Younger women with high FSH levels produced less but better quality embryos resulting in acceptable pregnancy rate. Conclusion: Female age is the most important prognostic factor. The basal FSH should be used to identify women who are purveyors of poor response to ART and should not be used to exclude them from fertility treatment.