Evaluation of age, basal FSH, LH, FSH/LH ratio and E2 levels in 800 patients as predictors of in vitro fertilization (IVF) outcome

Abstract

OBJECTIVE: To analyze to what extent age and the basal FSH, LH, FSH/LH ratio and E2 levels affect the results of ovarian stimulation and IVF outcome. Design: Retrospective cohort study. Setting: University hospital infertility centre. DESIGN: Retrospective cohort study. MATERIALS AND METHODS: Eight hundred patients undergoing their first cycle of IVF with ovarian stimulation after pituitary desensitization were included in the study. The patients were divided in different study groups according to their age and their basal FSH, LH, FSH/LH ratio and E2 levels. The biological and clinical parameters of the IVF outcome, cancellation rate, implantation rate, and pregnancy rate were evaluated in each group. RESULTS: Both increasing age and basal FSH were associated considerably with reduced numbers of oocytes collected and embryos available for transfer and degreased pregnancy rate. The combined use of age and basal FSH significantly improves the predictive power for these parameters. Increasing basal LH was significantly linked with degreased numbers of mature oocytes. A significant negative correlation was demonstrated between serum FSH concentration and cancellation and pregnancy rate. Elevated FSH/LH ratio was associated with fewer mature oocytes. CONCLUSIONS: Both basal FSH and woman's age are essential predictive factors of the outcome of IVF treatment, mainly for the achievement or not of pregnancy and for miscarriage rate. However FSH is a more important predictive factor. High levels of E2 (>75pg/ml) together with advanced age has great specificity. Elevated FSH/LH ratio in the beginning of the cycle may be vital for the quality of the oocytes and predicts a poor outcome in patients undergoing controlled ovarian stimulation for IVF.