Joiner Laura Lee Rihl, Robinson Randal D, Bates Wright, Propst Anthony M
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wilford Hall Medical Center, San Antonio Uniformed Services Health Education Consortium, Lackland Air Force Base, TX 78236, USA.
Mil Med. 2007 Feb;172(2):202-4. doi: 10.7205/milmed.172.2.202.
Elevated follicle-stimulating hormone (FSH) levels during the early follicular phase or in response to the clomiphene citrate challenge test indicate diminished ovarian reserve and poor reproductive potential. We performed a retrospective analysis of 413 infertile women, 23 to 40 years of age, who underwent 523 cycles of in vitro fertilization (IVF) to identify the critical FSH values that would predict a poor likelihood of success in our military IVF program. Each woman underwent a clomiphene citrate challenge test within 1 year of each IVF cycle. The overall live birth and implantation rates were 43% and 24%, respectively. The critical values for day 3 and day 10 FSH levels were 14.1 and 16.9 mIU/mL, respectively, with a 0% live birth rate and a 5% implantation rate above these levels. There were no differences in the live birth/implantation rates when stratified for FSH levels below the critical values. Medical centers offering IVF should determine their critical FSH values, to help identify patients unlikely to benefit from IVF and to ensure appropriate allocation of resources and realistic expectations for infertile couples.
卵泡期早期或对枸橼酸氯米芬激发试验反应时卵泡刺激素（FSH）水平升高表明卵巢储备功能减退和生殖潜力低下。我们对413名年龄在23至40岁之间接受了523个周期体外受精（IVF）的不孕女性进行了回顾性分析，以确定能够预测我们军队IVF项目成功率低的关键FSH值。每位女性在每个IVF周期的1年内都接受了枸橼酸氯米芬激发试验。总体活产率和着床率分别为43%和24%。第3天和第10天FSH水平的关键值分别为14.1和16.9 mIU/mL，高于这些水平时活产率为0%，着床率为5%。当按低于关键值的FSH水平分层时，活产/着床率没有差异。提供IVF的医疗中心应确定其关键FSH值，以帮助识别不太可能从IVF中受益的患者，并确保资源的合理分配以及对不孕夫妇的现实期望。
