Three pregnancies despite elevated serum FSH and advanced age: case report

Although the transfer of fertilized donor oocytes is the most efficacious mode of conception for infertile women with hypergonadotrophism associated with incipient or apparent ovarian failure, there are many individuals who, for religious, ethical, or personal reasons, would prefer to try to conceive with their own oocytes. The three cases presented here represent extremes to date for (i) highest serum FSH concentration in a woman with incipient ovarian failure (n = 2), and (ii) the oldest woman with apparent overt ovarian failure (n = 1) to have successful pregnancies. All three cases were treated for only a short time with pharmacological dosages of ethinyl oestradiol with luteal phase support with progesterone. The peak FSH (mIU/ml) in cases 1 and 2 was 143 and 127 respectively. The precedents set in these cases can help physician-patient consultation when patients enquire whether there is a certain critical FSH concentration above which pregnancy is not possible or an age over which successful pregnancy could not be achieved even if ovulation despite ovarian failure was possible.