High FSH should not preclude IVF

High FSH should not exclude IVF
Source: Fertility and Sterility 2004; 81: 1478-85
Women with elevated FSH levels have a reasonable chance of achieving ongoing pregnancy and should not be denied treatment.

The detection of raised levels of follicle stimulating hormone (FSH) at the initial infertility workup is not, on its own, sufficient reason to exclude a patient from treatment, researchers claim.

FSH levels are a popular indicator of ovarian reserve. Some reports suggest that elevated levels are predictive of low pregnancy rates, and recommend that affected patients should be denied treatment, but controversy remains.

Ilse van Rooij and team from the University Medical Center Utrecht in The Netherlands assessed ongoing pregnancy rates in subfertile women with elevated FSH levels and regular cycles.

Overall, ongoing pregnancy rates declined with increasing FSH concentration, falling from 65 percent with normal FSH (less than 10 IU/l) to 47 percent with FSH between 10 and 15 IU/l, and 28 percent with higher FSH levels.

After adjusting for age and whether or not patients had received treatment, however, the relationship "became inconsistent," the authors note, with a clear fall in ongoing pregnancy rates apparent only when FSH exceeded 20 IU/l.

While the authors recognize that FSH levels have some bearing on ongoing pregnancy rates, they point out that rates are still "quite acceptable" for levels greater than 15 IU/l.

"Therefore, [these patients] should not be automatically excluded from treatment based solely on elevated FSH levels," Rooij et al conclude.