Age and basal FSH: are they predictors of ART outcome?
Sonia Jellad (TN), Salima Daoued (TN), Mohamed Basly (TN), Mounir Chibani (TN), Radhouane Rachdi (TN)
[Jellad] Unit of Reproductive Biology- Military Hospital, [Daoued] Laboratory of Histology- Sfax Medicine university, [Basly] Unit of Reproductive Biology- Military Hospital, [Chibani] Unit of Reproductive Biology- Military Hospital, [Rachdi] Unit of Reproductive Biology- Military Hospital
Context: female age and basal FSH level are related to ovarian reserve. Objectives: to evaluate the role of basal FSH level associated with female age on ART outcome. Methods: a retrospective study including 376 ICSI cycles, basal FSH was measured using the same immunoenzymatic method for all patients before they were undergoing pituitary desensitization, all patients were stimulated using the long or short GnRH- protocol then patients were divided according to their age in two groups <38 and ≥ 38 years old .Each group was divided in two subgroups according to basal FSH levels: FSH<9.6, UI/l and ≥ 9.6 UI/l. Patients: 376 patients Interventions: ICSI Cycles Main outcome Measure: basal FSH, Clinical and biological ART outcome Results:Overall clinical pregnancy rate per cycle (PR) was: 25.45% in women aged<38 versus10.1% in >38 and cancellation rate was significantly lower in younger women (0.85% vs. 19.3%). The PR in subgroup of <38 and higher FSH was significantly higher 33.3% vs 10.6% in subgroup ≥ 38 years old with basal FSH< 9.6, UI/l (p<0.05), For the same age groups, the data showed that women with higher FSH levels were significantly associated with less number of oocytes retrieved and less number of embryos obtained (p<0.05. We observed more required total gonadotropin doses between the age groups of <38year old (higher FSH vs. normal FSH; p<0.05) but not in the age group of≥ 38 years old (p>0.05).cancellation rates were increased with increasing FSH in both age groups (P<0.0001). Conclusion: Increasing FSH was associated significantly with reduced oocytes retrieved, and embryos obtained, but there was no significant difference in terms of fertilization or pregnancy rate. Female age appears to be the most important prognostic factor but basal FSH can be used to identify women purveyors of poor response to ART.