Basal estradiol and follicle-stimulating hormone predict fecundity in women of advanced reproductive age undergoing ovulation induction therapy

Objective: To determine the prognostic value of single basal E-2 and FSH 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 medical center. Patient(s): Infertile couples in which the female partner was greater than or equal to 38 years old. Intervention(s): Single assessment of basal E-2 and FSH levels and ovulation induction with IUI. Main Outcome Measure(s): Cumulative and clinical pregnancy rates and live birth rates. Result(s): All live births occurred in patients with 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 equal to 13 mIU/mL), and no live births occurred in these couples. The cumulative 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%. Conclusion(s): Basal E-2 improves the ability to predict fertility potential compared with basal FSH and chronological age alone. Basal E-2, in combination with basal FSK and chronological age, has useful prognostic value in prospectively counseling patients of advanced reproductive age who are considering ovulation induction and IUI therapy. (C) 1997 by American Society for Reproductive Medicine.