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FSH and IVF management: the best and worst case scenarios

机译：FSH和IVF管理：最佳和最坏情况

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摘要

OBJECTIVE: A recent meta-analysis covering 21 studies shows that, when taken in isolation, the basal FSH level (commonly used to assess the ovarian reserve) is a poor indicator of successful in vitro fertilization (IVF) outcome. PATIENTS AND METHODS: We present a personal series of 3592 IVF procedures. Analysis of the results compares the age and basal FSH values, based on a statistical analysis that is essentially descriptive. RESULTS: When FSH levels are high, the pregnancy rate remains acceptable in young women (38 years); it drops sharply, however, in older women. In each age group, the rate of spontaneous miscarriage does not increase according to FSH level. The pregnancy rate is better in young women with high FSH levels than in older women with normal FSH levels. DISCUSSION AND CONCLUSION: The results presented agree with the studies published in the literature, which suggest that FSH is a prognostic factor for the quantity of oocytes obtained (ovarian reserve) while age defines the quality of the oocyte: it is this difference in quantity, and not in quality, which makes the difference between cases of poor and normal response to IVF. In young women at least, a high FSH level is not a contra-indication in principle for IVF.
机译：目的：最近一项涵盖21项研究的荟萃分析显示，孤立进行研究时，基础FSH水平（通常用于评估卵巢储备）不能很好地指示体外受精（IVF）结果的成功。患者和方法：我们介绍了3592个试管婴儿程序的个人系列。对结果的分析基于本质上是描述性的统计分析，比较了年龄和基础FSH值。结果：当FSH水平高时，年轻妇女（<38岁）的妊娠率仍然可以接受。然而，在老年妇女中，这一比例急剧下降。在每个年龄组中，自然流产的比率均不会随着FSH水平的升高而增加。 FSH水平高的年轻妇女的妊娠率要比FSH水平正常的老年妇女好。讨论与结论：给出的结果与文献中的研究一致，这表明FSH是获得的卵母细胞数量（卵巢储备）的预后因素，而年龄则决定了卵母细胞的质量：正是这种数量差异，而不是质量，这使得对IVF反应不良和正常的情况有所不同。至少在年轻女性中，高FSH含量并不是IVF的禁忌证。

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