BASAL ESTRADIOL AND FOLLICLE-STIMULATING-HORMONE PREDICT FECUNDITY INWOMEN OF ADVANCED REPRODUCTIVE AGE UNDERGOING OVULATION INDUCTION THERAPY

Objective: To determine the prognostic value of single basal E-2 and F SH levels as predictors of fecundity in women of advanced reproductive age who are undergoing ovulation induction with IUI therapy. Design: Prospective, observational. Setting: Fertility service of university m edical center. Patient(s): Infertile couples in which the female partn er was greater than or equal to 38 years old. Intervention(s): Single assessment of basal E-2 and FSH levels and ovulation induction with IU I. Main Outcome Measure(s): Cumulative and clinical pregnancy rates an d live birth rates. Result(s): All live births occurred in patients wi th a basal E-2 less than or equal to 80 pg/mL (conversion factor to SI unit, 3.671), a basal FSH less than or equal to 13 mIU/mL (conversion factor to SI unit, 1.00), and a chronological age less than or equal to 42 years. In women 38 to 42 years of age, 10.3% had elevated basal E-2 (>80 pg/mL) in combination with normal basal FSH (less than or equ al to 13 mIU/mL), and no live births occurred in these couples. The cu mulative live birth rate after four treatment cycles in women 38 to 42 years of age with both normal basal E-2 (less than or equal to 80 pg/ mL) and FSH levels (less than or equal to 13 mIU/mL) was 43.9%. Conclu sion(s): Basal E-2 improves the ability to predict fertility potential compared with basal FSH and chronological age alone. Basal E-2, in co mbination with basal FSK and chronological age, has useful prognostic value in prospectively counseling patients of advanced reproductive ag e who are considering ovulation induction and IUI therapy. (C) 1997 by American Society for Reproductive Medicine.