Objective:To determine ongoing pregnancy rates in subfertile patients with elevated FSH levels and regular cycles and to assess whether or not it is justified to exclude such patients from treatment on the basis of elevated FSH levels alone. Result(s):Overall ongoing pregnancy rates declined from 65% in the normal FSH group to 47%, and 28% in the respective elevated FSH groups. However, when adjusting for differences in age and whether or not treatment was applied, this declining trend became inconsistent for both treatment-independent and treatmentdependent ongoing pregnancy rates. Only when FSH levels exceeded 20 IU/L was a clear fall in ongoing pregnancy rate observed, independent of age. In a Cox regression analysis, FSH seemed significantly associated with the outcome time to overall ongoing pregnancy (odds ratio ϭ 0.94, 95% confidence interval, 0.88 -0.99), but after adjusting for age and being on treatment or not this significance disappeared (odds ratio ϭ 0.97, 95% confidence interval, 0.91-1.01). Conclusion(s):The contribution of FSH in the initial evaluation of subfertile couples is restricted to counseling patients on the probability of having lower chances of conceiving. It does not seem justified to exclude patients with normal regular cycles from treatment on the basis of the FSH value alone. (Fertil Steril 2004;81:1478 -85. ©2004 by American Society for Reproductive Medicine.) Key Words: FSH, subfertility, pregnancy, regular cycle With increasing female age, the probability of pregnancy declines (1, 2). This decline in fertility is most probably due to diminishing ovarian reserve, that is, the quantity and quality of the follicles in the ovary (3). However, biological variation exists in the ovarian reserve of women of the same age, and therefore chronological age alone may not give a reliable reflection of ovarian reserve.These observations led to the search for ovarian reserve tests, of which the measurement of FSH in the early follicular phase is the most common one. The value of FSH has been mainly tested in IVF populations. Those IVF patients with elevated FSH levels were shown to have lower pregnancy rates (4, 5), and the predictive value of FSH was better than age alone (6).Recently, some debate about the real clinical value of measuring FSH before IVF has arisen because investigators have found that FSH is of limited value in predicting ongoing

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