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Use of Follicle-Stimulating Hormone Test to Predict Poor Response in In Vitro Fertilization

Akira Iwase, MD, PhD^*, Hisao Ando, MD, PhD^*, Keiko Kuno, MD^* and Shigehiko Mizutani, MD, PhD^*

From the *Department of Obstetrics and Gynecology and Department of Maternal and Perinatal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.

OBJECTIVE: Optimized ovarian stimulation protocols are required for the success of in vitro fertilization (IVF). The purpose of this study was to estimate whether the ovarian reserve test using exogenous follicle-stimulating hormone (FSH) could predict ovarian response in IVF.

METHODS: This was a prospective observational study of 110 patients who underwent their first IVF cycle. The FSH test was administered as 150 IU of urinary FSH daily from day 3 to day 6 of the menstrual cycle preceding the IVF cycle for evaluation of the plasma estradiol level. Outcomes of IVF, including ovarian response, were analyzed.

RESULTS: A negative correlation was observed between the duration of stimulation and the result of the FSH test (r = –.238, P = .014) and between the dose of FSH per retrieved mature oocyte (metaphase II oocyte) and the result of the FSH test (r = –.308, P < .001). In addition, our results showed that the result of the FSH test was significantly lower in poor responders defined by FSH of 400 IU/metaphase II oocyte or greater (207 ± 149 compared with 293 ± 174 pg/mL, P = .007).

CONCLUSION: The FSH test can be a useful tool for determining the conditions of individualized clinical management plans and optimizing stimulation protocols in IVF.

LEVEL OF EVIDENCE: II-2

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