Skip to main content
SpringerLink
Log in

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

  • Research Paper
  • Published:
Science China Life Sciences Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    CAS  PubMed  Google Scholar 

  • Coccia, M.E., and Rizzello, F. (2008). Ovarian reserve. Ann New York Acad Sci 1127, 27–30.

    Article  CAS  Google Scholar 

  • 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Hofmann, G.E., Khoury, J., and Thie, J. (2000). Recurrent pregnancy loss and diminished ovarian reserve. Fertil Steril 74, 1192–1195.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tal, R., and Seifer, D.B. (2017). Ovarian reserve testing: a user’s guide. Am J Obstetrics Gynecol 217, 129–140.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

Download references

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).

Author information

Author notes

  1. Contributed equally to this work

Authors and Affiliations

  1. The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China

    Ziru Jiang, Li Jin, Weihui Shi, Ji Xi, Yulian Hu, Xinmei Liu, Guolian Ding & Hefeng Huang

  2. Institute of Embryo-Fetal Original Adult Disease, Shanghai Key Laboratory for Reproductive Medicine, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China

    Li Jin, Ji Xi, Yulian Hu, Xinmei Liu, Guolian Ding & Hefeng Huang

  3. Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Hangzhou, 310058, China

    Jianzhong Sheng

Authors
  1. Ziru Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Li Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Weihui Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ji Xi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yulian Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xinmei Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jianzhong Sheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Guolian Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hefeng Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Guolian Ding or Hefeng Huang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jiang, Z., Jin, L., Shi, W. et al. A combination of follicle stimulating hormone, estradiol and age is associated with the pregnancy outcome for women undergoing assisted reproduction: a retrospective cohort analysis. Sci. China Life Sci. 62, 112–118 (2019). https://doi.org/10.1007/s11427-018-9322-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11427-018-9322-6

Keywords

Search

Navigation