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Predictive value of basal follicle-stimulating hormone concentrations in a general subfertility population
J M van Montfrans1, A Hoek, M H van Hooff
1Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Objective:
To assess the predictive value of elevated basal FSH concentrations during the initial subfertility workup with respect to fecundity in a general subfertility population with ovulatory menstrual cycles.
Design:
Nested case-control study.
Setting:
Fertility center of a university hospital.
Patient(S):
Fifty subfertile women with basal FSH levels >10.0 IU/L and 50 age-matched controls.
Intervention(S):
Long-term follow-up (3-7 years).
Main Outcome Measure(S):
Pregnancies, deliveries, and time to pregnancy.
Result(S):
Patients with elevated basal FSH levels and controls were comparable with regard to basic characteristics, clinical diagnoses, and subfertility treatment. Long-term follow-up showed that 52% of the women with elevated basal FSH concentrations became pregnant (positive predictive value 48%) versus 62% of the controls, and 42% versus 46% eventually delivered a child, respectively. The mean time to pregnancy was 3.0 years in the elevated-FSH group and 3.4 years in controls. Most of the pregnancies in both groups occurred after spontaneous conceptions.
Conclusion(S):
The results of this study suggest that screening for elevated basal FSH concentrations is of no additional value in a general subfertility population with ovulatory menstrual cycles.