Basal follicle-stimulating hormone levels are of limited value in predicting ongoing pregnancy rates after in vitro fertilization

Objective: To evaluate whether basal FSH (bFSH; measured on menstrual day 1 -4) adds relevant clinical information to the prediction of ongoing pregnan cy rates (OPRs) after NF, once age and diagnostic characteristics have been taken into account. Design: Retrospective. Setting: Academic fertility center. Patient(s): 435 women undergoing their first IVF cycle. Intervention(s): None. Main Outcome Measure(s): Ongoing pregnancy rate. Result(s): The likelihood ratio of bFSH as a single prognosticator for trea tment failure at a cutoff level of 15 nm was 3.87. The proportion of patien ts with such a bFSH level was 5%. Multivariate logistic regression analysis selected age, bFSH level, and infertility diagnosis as relevant predictors of ongoing pregnancy. When compared to a predictive model for OPRs based o n age and infertility diagnosis, the Inclusion of bFSH into this model help ed to identify more patients (22 vs. 1) whose predicted OPR decreased from a low level (5%-12%) towards an extremely low level (<5%). Conclusion(s): An acceptable performance of bFSH as a single test to predic t treatment failure is only obtained above a high cutoff level. Thus, the n umber of patients for whom bFSH provides relevant information is small. The predictive model including bFSH identified significantly more patients wit h an extremely poor prognosis than did the predictive model without bFSH. H owever, predictions based solely on age and infertility diagnosis usually w ere already poor in these patients. Measurement of bFSH adds Little in only a few patients and is, therefore, debatable. (C) 2000 by American Society for Reproductive Medicine.