In a nutshell
This study explored factors that can affect pregnancy rates in patients with a high follicle-stimulating hormone level undergoing in vitro fertilization.
Some background
Follicle stimulating hormone (FSH) levels are used to assess a females’ ovarian function. If FSH levels are unexpectedly high for the patient's age it can indicate a reduced reserve of oocytes (eggs). This can result in difficulties conceiving and giving birth.
In-vitro fertilization (IVF) is when a male sperm fertilizes the females’ egg in a laboratory dish outside the body, this is implanted into the woman's uterus (womb). Intra-cytoplasmic sperm injection (ICSI) is similar but a single sperm is injected directly into an egg.
Up to 50% of IVF cycle cancellations occur due to decreased ovarian reserve. Methods of predicting pregnancy rates in women undergoing IVF with increased FSH would be useful.
Methods & findings
58 females aged 21 to 43 years undergoing IVF were included in this study. All patients had an FSH level of at least 12 IU/L (considered high). Patients underwent one to four IVF/ICSI cycles. All procedures used fresh embryos.
The pregnancy (a positive pregnancy test) rate (percentage of all IVF/ICSI attempts that led to pregnancy) was 22.4%. Clinical pregnancy rates (a sac containing a fetus is visible on ultrasound 6-8 weeks after implantation) was 14% per patient. The rate of miscarriage was 22% per pregnancy. Ectopic pregnancies (unsustainable pregnancy outside the womb), occurred at a rate of 15% of per pregnancy.
The average highest FSH levels were very similar in those who did and did not conceive.
An increased number of mature follicles (a structure found in ovaries where an oocytes mature) was associated with a higher rate of clinical pregnancy. Higher clinical pregnancy rates occurred in females that had an increase in the number of oocytes retrieved from the ovary and developed embryos (fertilized eggs) 24 hours after oocyte retrieval.
The bottom line
This study concluded that oocyte and and embryo quantity predicted IVF success in women with increased FSH. The authors suggested that increased FSH levels should not discourage women from attempting IVF, as pregnancy is possible in some cases.
The fine print
This study had a small number of participants, a larger study may improve the accuracy of results.
The number of live births that occurred was not included in the study.
What’s next?
Talk to your physician if you have a high FSH level and would like to try IVF.
Published By :
PLOS ONE
Date :
Apr 13, 2015
