Purpose: This work investigates the relationship of basal follicle stimulating hormone (FSH) measurements and age to ovarian responsiveness and pregnancy occurrence following controlled ovarian hyperstimulation and intrauterine insemination (COH-IUI).
Method: Basal FSH was measured retrospectively in sera from infertility patients obtained on cycle day 2, 3, or 4 of a COH-IUI treatment cycle. Basal FSH was then correlated with COH response parameters and treatment outcome in ovulatory (n = 98) and anovulatory (n = 33) patients. Clinical data were collected from retrospective chart review. In the ovulatory group, increasing basal FSH was associated with fewer follicles (P = 0.01) and lower peak estradiol (P = 0.0001).
Results: No age related effects were detected in the anovulatory group. Also, there were no pregnancies in this group when basal FSH was > 22.1 mIU/ml. Increasing age in the ovulatory group was associated with fewer follicles (P = 0.0001), lower peak estradiol (P = 0.0001), and fewer pregnancies (P = 0.04). In the anovulatory group, basal FSH did not correlate with follicle numbers or peak estradiol, although more ampoules of hMG were used for stimulation (P = 0.03).
Conclusions: Increasing basal FSH and patient age both correlated inversely with ovarian responsiveness to COH in ovulatory patients. Basal FSH can be used in clinically to identify patients undergoing COH who are unlikely to respond to superovulatory drugs and unlikely to become pregnant.