THE PREDICTIVE VALUE OF BASAL FOLLICLE-STIMULATING AND GROWTH-HORMONE LEVELS AS DETERMINED BY IMMUNOFLUOROMETRY DURING ASSISTED REPRODUCTION

被引:16
作者
HUYSER, C
FOURIE, FLR
PENTZ, J
HURTER, P
机构
[1] Centre for Fertility Studies, Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, 0002
[2] Department of Chemical Pathology, University of Pretoria, Pretoria
关键词
ASSISTED REPRODUCTION; AGE; IMMUNOFLUOROMETRIC ASSAY; FOLLICLE STIMULATING HORMONE; GROWTH HORMONE;
D O I
10.1007/BF02212926
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Purpose: Our purpose was (a) to investigate relationships of baseline endocrine serum levels with selected assisted reproduction (AR) parameters and (b) to evaluate the clinical applicability of an immunofluorometric assay (IFMA) as an alternative to a radioimmunoassay (RIA). Methods: Basal endocrine values (analyzed by RIA-rFSH, rLH, and rE(2); analyzed by IFMA-fFSH, fLH, and fGH) were determined for female patients (n = 142) preceding ovarian stimulation for AR. Results: Specific AR parameters correlated significantly with RIA- and IFMA-determined FSH levels, although IFMA correlations consistently exceeds that of RIA. Cutoff values of fFSH greater than or equal to 11.68 IU/L or rFSH greater than or equal to 15.0 IU/L indicated a poor response. The high-basal fFSH group was older (34 vs 31 years; P = 0.0334) and yielded fewer oocytes (2.9 vs 4.6 oocytes; P = 0.0018) than the low-basal fFSH group (< 11.68 IU/L). Lower cumulative embryo scores and conception rates were also associated with the high-fFSH group, compared to the low-fFSH group. Conclusions: This study confirms the negative impact of elevated basal FSH levels on AR. Basal LH, GH, and E(2) levels are, in comparison to baseline FSH levels, unsuitable indices for estimating ovarian responsiveness. IFMA can be regarded as an alternative to RIA in both clinical and research laboratories.
引用
收藏
页码:244 / 251
页数:8
相关论文
共 39 条
[1]  
Benshushan A., Schenker J.G., Reproductive health care policies around the world. Age limitation in human reproduction: Is it justified?, J Assist Reprod Genet, 10, pp. 321-331, (1993)
[2]  
Padilla S.L., Garcia J.E., Effect of maternal age and number of in vitro fertilization procedures on pregnancy outcome, Fertil Steril, 52, pp. 270-273, (1989)
[3]  
Meldrum D.R., Female reproductive aging—Ovarian and uterine factors, Fertil Steril, 59, pp. 1-5, (1993)
[4]  
Hollander D., Breen J.L., Pregnancy in the older gravida: How old is old?, Obstet Gynecol Surv, 45, pp. 106-112, (1990)
[5]  
Metcalf M.G., Livesey J.H., Gonadotropin excretion in fertile woman: effect of age and the onset of menopausal transition, Obstetrical & Gynecological Survey, 41, pp. 101-103, (1986)
[6]  
Gindoff P.R., Jewelewicz R., Reproductive potential in the older woman, Fertil Steril, 46, pp. 989-1001, (1986)
[7]  
Toner J.P., Philput C.B., Jones G.S., Muasher S.J., Basal folliclestimulating hormone level is a better predictor of in vitro fertilization performance than age, Fertil Steril, 55, pp. 784-791, (1991)
[8]  
Toner J.P., The significance of elevated FSH for reproduction function, Baillieres Clin Obstet Gynaecol, 7, pp. 283-295, (1993)
[9]  
Urdl W., Auner J., Walcher W., Giuliani A., Mahnert W., Basal FSH concentrations and age as prognostic factors in IVF, 10th Annu Meet Eur Soc Hum Reprod, 9, pp. 193-194, (1994)
[10]  
Sherman B.M., West J.H., Korenman S.G., The menopausal transition: Analysis of LH, FSH, estradiol, and progesterone concentrations during menstrual cycles of older women, J Clin Endocrinol Metab, 42, pp. 629-636, (1976)