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  • Title: Infertile women of advanced reproductive age. Variability of day 3 FSH and E2 levels.
    Author: Buyalos RP, Ghosh K, Daneshmand ST.
    Journal: J Reprod Med; 1998 Dec; 43(12):1023-6. PubMed ID: 9883405.
    Abstract:
    OBJECTIVE: To evaluate the variability of basal (day 3) levels of follicle stimulating hormone (FSH) and estradiol (E2) in infertile women of advanced reproductive age. STUDY DESIGN: Retrospective analysis of day 3 FSH and E2 concentrations measured serially in patients of advanced reproductive age at a tertiary university fertility center. RESULTS: Forty-seven infertile women > or = 38 years of age (range, 38-47) undergoing ovulation induction therapy had basal FSH and E2 levels measured on two or more cycles within a two-year periods. During the study period all live births occurred in patients with day 3 FSH values < or = 13 mIU/mL and E2 values < or = 80 pg/mL, and these values were used as normative cutoffs for favorable ovarian reserve. Eleven of 38 women (28.9%) demonstrated a shift in basal values of FSH and/or E2 from the normal to the abnormal range in a subsequent cycle. Of these 11 women, 10 (90.9%) demonstrated a shift of only one hormone (FSH, n = 6) or (E2, n = 4) from the normal to the elevated range. One of 47 women (2.1%) had a shift of both basal FSH and E2 from the normal to the elevated range in a subsequent cycle. All patients who presented with or later developed an elevated day 3 level of FSH and/or E2 had persistent elevations of one or both hormones in all subsequent measurements. CONCLUSION: Day 3 FSH and/or E2 concentrations shifted from the normal to the abnormal range in 28.9% of an infertile patient population of advanced reproductive age screened serially within a two-year period. We hypothesize that serial assessment of basal FSH in combination with E2 will improve the ability to detect diminished ovarian reserve in infertile women of advanced reproductive age.
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