FOLLICLE-STIMULATING-HORMONE LEVELS ON CYCLE DAY 3 TO PREDICT OVARIANRESPONSE IN WOMEN UNDERGOING CONTROLLED OVARIAN HYPERSTIMULATION FOR IN-VITRO FERTILIZATION USING A FLARE-UP PROTOCOL

Objective: To determine whether cycle day 3 serum FSH levels predict p oor ovarian response and cycle cancellation in women undergoing contro lled ovarian hyperstimulation (COH) for IVF. Design: Prospective case series. Setting: University hospital IVF program. Patient(s): The stud y includes outcomes of 637 initial cycles of IVF. Intervention(s): Con trolled ovarian hyperstimulation was undertaken with a short, flare-up GnRH agonist and hMG protocol. The relation of cycle day 3 FSH levels with various cycle characteristics and outcomes was determined. Main Outcome Measure(s): The accuracy of cycle day 3 FSH levels in predicti ng poor ovarian response and cycle cancellation was evaluated. Receive r operating characteristic curves were constructed to determine the op timum cutoff value for the cycle day 3 serum FSH level that best predi cted poor ovarian response and cycle cancellation. Result(s): A cycle day 3 serum FSH level greater than or equal to 13 mIU/mL (conversion f actor to SI unit, 1.00) was associated with a high likelihood of poor ovarian response and cycle cancellation. The sensitivity, specificity, and positive likelihood ratio of an FSH level of 13 mIU/mL in predict ing cycle cancellation were 52%, 91%, and 6.04, respectively. Conclusi on(s): Cycle day 3 FSH screening appears to be a fairly accurate predi ctor of poor ovarian response and cycle cancellation in women undergoi ng COH using a short, flare-up GnRH agonist and hMG protocol. (C) 1997 by American Society for Reproductive Medicine.