Advertisement

A combination of follicle stimulating hormone, estradiol and age is associated with the pregnancy outcome for women undergoing assisted reproduction: a retrospective cohort analysis

  • Ziru Jiang
  • Li Jin
  • Weihui Shi
  • Ji Xi
  • Yulian Hu
  • Xinmei Liu
  • Jianzhong Sheng
  • Guolian Ding
  • Hefeng Huang
Open Access
Research Paper
  • 29 Downloads

Abstract

To investigate the effect of basal hormone levels including follicle stimulating hormone (FSH) and estradiol (E2) and age on the pregnancy outcomes in women undergoing in vitro fertilization and embryo transfer (IVF-ET), we designed a retrospective cohort analysis and collected information of patients undergoing IVF between January 2014 and April 2017. We found that young women had much better pregnancy outcomes than older women regardless of the hormone levels. The pregnancy outcomes declined in young women with high basal E2, even though they had normal FSH. Older women with higher FSH had a worse outcome of pregnancy, especially with increased E2 level. The results suggest that a combination of FSH, E2 and age could effectively predict the pregnancy outcome for women undergoing IVF-ET, and we should encourage infertile women with diminished ovarian reserve, especially young infertile women, to try the assisted reproduction as early as possible. After 40-yearold, the cost-benefit ratio should be considered according to the ovarian function.

Keywords

follicle stimulating hormone estradiol age pregnancy outcome assisted reproduction 

Notes

Acknowledgements

We are very grateful to the support of the International Peace Maternity and Child Health Hospital for the project. Thanks to all clinic staff who helped to access to medical records. This work was supported by the Special Fund for the National Key Research and Development Plan Grant (2017YFC1001300 to Hefeng Huang and Guolian Ding), the Major Program of National Natural Science Foundation of China (81490742 to Hefeng Huang), the National Natural Science Foundation of China (31571556 to Guolian Ding), and the Municipal Human Resources Development Program for Outstanding Young Talents in Medical and Health Sciences in Shanghai (2017YQ047 to Guolian Ding).

References

  1. Abdalla, H., and Thum, M.Y. (2004). An elevated basal FSH reflects a quantitative rather than qualitative decline of the ovarian reserve. Hum Reprod 19, 893–898.CrossRefPubMedGoogle Scholar
  2. Akande, V.A., Fleming, C.F., Hunt, L.P., Keay, S.D., and Jenkins, J.M. (2002). Biological versus chronological ageing of oocytes, distinguishable by raised FSH levels in relation to the success of IVF treatment. Hum Reprod 17, 2003–2008.CrossRefPubMedGoogle Scholar
  3. Bishop, L.A., Richter, K.S., Patounakis, G., Andriani, L., Moon, K., and Devine, K. (2017). Diminished ovarian reserve as measured by means of baseline follicle-stimulating hormone and antral follicle count is not associated with pregnancy loss in younger in vitro fertilization patients. Fertil Steril 108, 980–987.CrossRefPubMedGoogle Scholar
  4. Check, J.H., Nazari, P., Check, M.L., Choe, J.K., and Liss, J.R. (2002). Prognosis following in vitro fertilization-embryo transfer (IVF-ET) in patients with elevated day 2 or 3 serum follicle stimulating hormone (FSH) is better in younger vs older patients. Clin Exp Obstet Gynecol 29, 42–44.PubMedGoogle Scholar
  5. Coccia, M.E., and Rizzello, F. (2008). Ovarian reserve. Ann New York Acad Sci 1127, 27–30.CrossRefGoogle Scholar
  6. Cohen, J., Chabbert-Buffet, N., and Darai, E. (2015). Diminished ovarian reserve, premature ovarian failure, poor ovarian responder—a plea for universal definitions. J Assist Reprod Genet 32, 1709–1712.CrossRefPubMedPubMedCentralGoogle Scholar
  7. De Sutter, P., and Dhont, M (2003). Poor response after hormonal stimulation for in vitro fertilization is not related to ovarian aging. Fertil Steril 79, 1294–1298.CrossRefPubMedGoogle Scholar
  8. Esposito, M.A., Coutifaris, C., and Barnhart, K.T. (2002). A moderately elevated day 3 FSH concentration has limited predictive value, especially in younger women. Hum Reprod 17, 118–123.CrossRefPubMedGoogle Scholar
  9. Hansen, L.M., Batzer, F.R., Gutmann, J.N., Corson, S.L., Kelly, M.P., and Gocial, B. (1996). Evaluating ovarian reserve: follicle stimulating hormone and oestradiol variability during cycle days 2–5. Hum Reprod 11, 486–489.CrossRefPubMedGoogle Scholar
  10. Hofmann, G.E., Khoury, J., and Thie, J. (2000). Recurrent pregnancy loss and diminished ovarian reserve. Fertil Steril 74, 1192–1195.CrossRefPubMedGoogle Scholar
  11. Kushnir, V.A., Safdie, M., Darmon, S.K., Albertini, D.F., Barad, D.H., and Gleicher, N. (2018). Age-specific IVF outcomes in infertile women with baseline FSH levels 20 mIU/mL. Reprod Sci 25, 893–898.CrossRefPubMedGoogle Scholar
  12. Lathi, R.B., and Kort, J.D. (2016). Caution: counseling patients with diminished ovarian reserve and recurrent pregnancy loss about in vitro fertilization with preimplantation genetic screening. Fertil Steril 106, 1041–1042.CrossRefPubMedGoogle Scholar
  13. Licciardi, F.L., Liu, H.C., and Rosenwaks, Z. (1995). Day 3 estradiol serum concentrations as prognosticators of ovarian stimulation response and pregnancy outcome in patients undergoing in vitro fertilization. Fertil Steril 64, 991–994.CrossRefPubMedGoogle Scholar
  14. Muasher, S.J., Oehninger, S., Simonetti, S., Matta, J., Ellis, L.M., Liu, H.C., Jones, G.S., and Rosenwaks, Z. (1988). The value of basal and/or stimulated serum gonadotropin levels in prediction of stimulation response and in vitro fertilization outcome. Fertil Steril 50, 298–307.CrossRefPubMedGoogle Scholar
  15. Pastore, L.M., Christianson, M.S., Stelling, J., Kearns, W.G., and Segars, J. H. (2018). Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR. J Assist Reprod Genet 35, 17–23.CrossRefPubMedGoogle Scholar
  16. Rasool, S., and Shah, D. (2017). Fertility with early reduction of ovarian reserve: the last straw that breaks the Camel’s back. Fertil Res Pract 3, 15.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Steiner, A.Z., Pritchard, D., Stanczyk, F.Z., Kesner, J.S., Meadows, J.W., Herring, A.H., and Baird, D.D. (2017). Association between biomarkers of ovarian reserve and infertility among older women of reproductive age. JAMA 318, 1367–1376.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Tal, R., and Seifer, D.B. (2017). Ovarian reserve testing: a user’s guide. Am J Obstetrics Gynecol 217, 129–140.CrossRefGoogle Scholar
  19. van Rooij, I.A.J., Bancsi, L.F.J.M.M., Broekmans, F.J.M., Looman, C.W. N., Habbema, J.D.F., and te Velde, E.R. (2003). Women older than 40 years of age and those with elevated follicle-stimulating hormone levels differ in poor response rate and embryo quality in in vitro fertilization. Fertil Steril 79, 482–488.CrossRefPubMedGoogle Scholar
  20. Wiser, A., Shalom-Paz, E., Reinblatt, S.L., Son, W.Y., Das, M., Tulandi, T., and Holzer, H. (2012). Ovarian stimulation and intrauterine insemination in women aged 40 years or more. Reprod Biomed Online 24, 170–173.CrossRefPubMedGoogle Scholar

Copyright information

© Science China Press and Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ziru Jiang
    • 1
  • Li Jin
    • 1
    • 2
  • Weihui Shi
    • 1
  • Ji Xi
    • 1
    • 2
  • Yulian Hu
    • 1
    • 2
  • Xinmei Liu
    • 1
    • 2
  • Jianzhong Sheng
    • 3
  • Guolian Ding
    • 1
    • 2
  • Hefeng Huang
    • 1
    • 2
  1. 1.The International Peace Maternity and Child Health Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
  2. 2.Institute of Embryo-Fetal Original Adult Disease, Shanghai Key Laboratory for Reproductive Medicine, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
  3. 3.Department of Pathology and Pathophysiology, School of MedicineZhejiang UniversityHangzhouChina

Personalised recommendations