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

Abstract

To investigate the effect of basal hormone levels including follicle stimulating hormone (FSH) and estradiol (E) 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 E, even though they had normal FSH. Older women with higher FSH had a worse outcome of pregnancy, especially with increased E level. The results suggest that a combination of FSH, E 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.

The development of using nomogram to predict pregnancy outcomes of emergency oocyte freeze-thaw cycles

“…Some studies also suggested that the FSH level on cycle day 3 was a better indicator of IVF outcome than female age [24]. High levels of basal E2 level were associated with low oocyte yields, low pregnancy rates and higher cancellation rate independent of FSH levels [25,26]. Our results are consistent with the above studies.…”

Aging attenuates the ovarian circadian rhythm

“…Women generally reach peak reproductive potential well before the age of 30 and then experience a slow decline in reproductive potential until the age of 40, at which point the decline becomes more precipitous [18]. Although IVF-ET is the most effective treatment for women who are > 40 years old [15], the success rate for older women is still very low [16]. It is commonly known that fertility decreases with advancing age.…”

“…In our previous study, we found that, compared with young patients, older patients showed significantly decreased numbers of retrievable oocytes and available embryos and had a lower clinical pregnancy rate after assistant reproductive technology. In addition, we compared the final outcomes between young and old pregnant women and found that older women have significantly increased miscarriage rates and decreased live birth rates [16].…”

“…Even with assisted reproductive techniques, such as in vitro fertilization and embryo transfer (IVF-ET), the pregnancy outcome is still poor [15]. Our previous study also suggested that older women may have lower fertility and lower live birth rates [16]. Because a decline in the ovarian reserve is one of the main reasons for the decline in fertility among older women, especially women after the age of 40, we investigated the expression of circadian genes in human granulosa cells from young and older women, and, the expression of circadian genes in ovarian tissues from young and older female mice to explore the effect of aging on the ovarian clock.…”

“…As women get older, the quality and quantity of their oocytes decline, as does the pregnancy rate for older women [15,16]. Even with assisted reproductive techniques, such as in vitro fertilization and embryo transfer (IVF-ET), the pregnancy outcome is still poor [15].…”