The prognostic value of age and follicle-stimulating hormone levels in women over forty years of age undergoing in vitro fertilization

Purpose: Basal follicle-stimulating hormone (FSH) and age are predictors of successful outcome in in vitro fertilization (IVF). More recently, the clo miphene citrate challenge test (CCCT) has been proposed as a better way to predict IVF outcome than FSH alone. The purpose of this study uas to determ ine which indicator of ovarian reserve-basal (day 3) FSH or the CCCT-is the better predictor of NF success in the critical age group of women over the age of 40. Methods: In this retrospective study, basal FSH and clomiphene-stimulated F SH levels from 104 women Lt ho underwent 175 cycles of IVF were analyzed. Results: Neither basal FSH level nor stimulated FSH level alone were statis tically significant predictors of IVF success, however: no patient with a d ay 3 FSH level >11.1 mIU/ml or a stimulated day 10 FSH level >13.5 mIU/ml c onceived and carried a pregnancy All ongoing pregnancies occurred in the fi rst two cycles of IVF. Conclusions: Clear prognostic cutoff values were found to predict IVF succe ss in women over age 40, IVF programs should consider limiting the number o f cycles of NF in women above age 40.