DISCRIMINATION BETWEEN CHRONOLOGICAL AND OVARIAN AGE IN INFERTILE WOMEN AGED 35 YEARS AND OLDER - PREDICTING PREGNANCY USING BASAL FOLLICLE-STIMULATING-HORMONE, AGE AND NUMBER OF OVULATION INDUCTION INTRAUTERINE INSEMINATION CYCLES

A marked decline in fertility rates has been demonstrated in women >35 years of age. We have previously demonstrated the importance of basal follicle stimulating hormone (FSH) concentrations plus chronological age to predict pregnancies in women aged greater than or equal to 40 y ears undergoing ovulation induction therapy. The purpose of the curren t study was to extend our previous study and determine the impact of a ge, basal FSH concentrations and ovulation induction/intra-uterine ins emination (IUI) treatment cycles on pregnancy rates in infertile women aged greater than or equal to 35 years. This prospective observationa l study was performed at a tertiary university fertility centre. Asses sments of basal hormonal status and ovulation induction protocols were performed. The main outcome measured was clinical pregnancies, A tota l of 770 treatment cycles in 179 women aged greater than or equal to 3 5 years were analysed. The impact of basal FSH concentrations on treat ment outcomes could be bifurcated into a favourable group (FSH less th an or equal to 23 mIU/ml) and a poor prognosis group (FSH greater than or equal to 24 mIU/ml). A multivariate logistic regression model was generated which accurately predicted pregnancies. There was a high deg ree of correlation between predicted pregnancies and observed pregnanc ies (r = 0.86). We conclude that age, number of treatment cycles and t he interaction term basal FSH X age are useful and significant predict ors of pregnancies in patients aged greater than or equal to 35 years undergoing ovulation induction/IUI therapy.