Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
Department of Obstetrics and Gynecology, Stanford University, Stanford, California, United States of America.
PLoS One. 2015 Apr 13;10(4):e0124789. doi: 10.1371/journal.pone.0124789. eCollection 2015.
The purpose of this study is to evaluate factors predictive of outcomes in women with highest follicle-stimulating hormone (FSH) levels ≥ 12 IU/L on basal testing, undergoing in vitro fertilization (IVF).
A prospective cohort study was conducted at Stanford University Hospital in the Reproductive Endocrinology and Infertility Center for 12 months. Women age 21 to 43 undergoing IVF with highest FSH levels on baseline testing were included. Donor/Recipient and frozen embryo cycles were excluded from this study. Prognostic factors evaluated in association with clinical pregnancy rates were type of infertility diagnosis and IVF stimulation parameters.
The current study found that factors associated with clinical pregnancy were: increased number of mature follicles on the day of triggering, number of oocytes retrieved, number of Metaphase II oocytes if intracytoplasmic sperm injection was done, and number of embryos developed 24 hours after retrieval.
Our findings suggest that it would be beneficial for women with increased FSH levels to attempt a cycle of IVF. Results of ovarian stimulation, especially embryo quantity appear to be the best predictors of IVF outcomes and those can only be obtained from a cycle of IVF. Therefore, increased basal FSH levels should not discourage women from attempting a cycle of IVF.
本研究旨在评估基础检测中卵泡刺激素(FSH)水平最高≥12IU/L 的女性进行体外受精(IVF)的结局预测因素。
本前瞻性队列研究在斯坦福大学医院生殖内分泌和不孕不育中心进行了 12 个月。纳入年龄在 21 至 43 岁之间,基础检测 FSH 水平最高,行 IVF 的女性。本研究排除了供体/受体和冷冻胚胎周期。评估与临床妊娠率相关的预测因素为不孕诊断类型和 IVF 刺激参数。
本研究发现与临床妊娠相关的因素有:触发日成熟卵泡数量增加、获卵数、如果进行胞浆内精子注射则获成熟 II 期卵母细胞数,以及取卵后 24 小时发育的胚胎数。
我们的研究结果表明,对于 FSH 水平升高的女性来说,尝试进行 IVF 周期是有益的。卵巢刺激的结果,尤其是胚胎数量似乎是 IVF 结局的最佳预测因素,而这些只能通过 IVF 周期获得。因此,基础 FSH 水平升高不应阻止女性尝试进行 IVF 周期。