Elevated day 3 serum follicle stimulating hormone and/or estradiol may predict fetal aneuploidy

Nasseri, Ali; Mukherjee, Tanmoy; Grifo, James A.; Noyes, N.; Krey, L.C.; Copperman, A.B.

doi:10.1016/s0015-0282(98)00525-1

Cited by 129 publications

(71 citation statements)

References 24 publications

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“…This is felt by some to be due to poorer oocyte quality and/or increased fetal aneuploidy rates (39)(40)(41)(42)(43)(44), although Abdalla and Thum were unable to confirm this association in their study (30).…”

Section: Other Potential Benefits Of Separating Age-related From Non-mentioning

confidence: 88%

A new approach to ovarian reserve testing

Sun

Stegmann

Henne

et al. 2008

Fertility and Sterility

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Objective-To critically examine ovarian reserve testing prior to assisted reproduction. Design-A PUBMED computer search to identify relevant literature. Setting-Multiple sites Interventions-Testing for ovarian reserve Main Outcome Measures-IVF and pregnancy outcomesResult(s)-The prevalence of ovarian insufficiency varies significantly for women aged 30-45 years. Generalization or averaging of threshold values across different aged women leads to very poor sensitivity, specificity, and positive predictive value for all tests of ovarian reserve. Because of the changing prevalence of ovarian insufficiency, there is no single, suitable threshold value for any screening test of ovarian reserve. Our analysis supports dividing impaired ovarian reserve into two groups: age-dependent ovarian aging (physiologic) and premature (non-physiologic) reductions in the oocyte pool. Interpretation of any screening test used requires that age is considered as a variable. To guide clinical interpretation of test results, we suggest using a nomogram of FSH values versus expected delivery rate-per-cycle-start with ART for a given age. Conclusions(s)-Proper interpretation of screening tests for ovarian insufficiency in couplesconsidering ART is important since the presence of impaired ovarian reserve is associated with a low likelihood of pregnancy. The condition of premature (non-physiologic) ovarian insufficiency warrants additional research. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. More than 100 years ago, population studies clearly documented a decrease in fertility with increasing age (1). In today's culture of widely available birth control and workforce equality, women often delay child-bearing to pursue a career. As a result, the childbearing age for women has been delayed from the 20's to the 30's and even into the early 40s (2). This societal shift has resulted in an increase in the number of women who are interested in fertility and have regular cycles, but who are subfertile due to a reduction in their oocyte (egg) supply. Recognition of the profound adverse effect of a reduction in oocyte supply on fertility led to the concept of ovarian reserve and the moniker of 'Diminished Ovarian Reserve' (DOR (5,13,14). NIH Public AccessThe pathophysiology associated with the age-related reduction in fertility (1) is a reduction in the oocyte pool accompanied by an increase in FSH due to reduced feedback from estrogen and inhibins (15). There are also reduced levels of hormones such as anti-Mullerian hormone (AMH) (16). Theoretically, in some women the reduction in the oocyte po...

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Section: Other Potential Benefits Of Separating Age-related From Non-mentioning

confidence: 88%

A new approach to ovarian reserve testing

Sun

Stegmann

Henne

et al. 2008

Fertility and Sterility

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“…The FSH level is a reasonably good predictor of response to stimulation (reflecting the number of remaining oocytes and the size of the recruitable cohort) in IVF cycles but predicts pregnancy (reflecting oocyte quality) with significantly less accuracy (Muasher et al, 1988;Toner et al, 1991;Sharif et al, 1998;Toner, 2003;Jain et al, 2004). However, women having a 'reduced ovarian complement' (related to congenital absence or ovarian surgery) are at an increased risk for conceiving an aneuploid pregnancy, suggesting that ovarian reserve and oocyte quality are linked, and numerous studies have observed that higher FSH levels are associated with an increased incidence of aneuploidy, independent of maternal age (Nasseri et al, 1999;van Montfrans et al, 1999;Freeman et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Examining the relationship between ovarian reserve, as measured by basal FSH levels, and the risk of poor obstetric outcome in singleton IVF gestations

2011

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background: The higher prevalence of preterm birth (PTB) and low birthweight (LBW) following infertility treatment may relate to the treatment itself or indicate that subfertility predisposes to a higher risk. Our aim was to examine whether basal FSH levels are related to the risk for PTB and LBW among pregnancies resulting from IVF. methods:We studied a retrospective cohort in the 2008 National Society for Assisted Reproductive Technology Database, including all women who underwent a fresh non-donor IVF cycle resulting in a singleton live birth having a recorded basal serum FSH value (n ¼ 14 262). The FSH value used was either the maximum basal or clomiphene-stimulated serum level. Log binomial models were created to assess the associations between FSH and PTB (,37 weeks), and between FSH and LBW (,2500 g), adjusting for maternal age, ethnicity, gravidity/ parity, history of PTB, smoking, BMI and infant gender.results: Data for 14 086 patients were analyzed. FSH levels were inversely related to the risk of PTB and LBW. Women in the highest quartile of FSH levels (≥9 mIU/ml) had the longest adjusted mean gestational age (271.2 days), the lowest adjusted relative risk (RR) of PTB [0.87, 95% confidence interval (CI): 0.76 -1.01], the highest adjusted mean birthweight (3249 g) and the lowest adjusted RR of LBW (0.89, 95% CI: 0.73 -1.04).conclusions: The inverse relationship between maximal basal FSH levels and the risk for PTB and LBW in singleton IVF gestations suggests that diminished ovarian reserve is not the primary mediator of the increased prevalence of PTB and LBW in IVF pregnancies.

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“…Multiple investigators have explored the possible link between diminished ovarian reserve and fetal aneuploidy [14,[23][24][25][26][27][28][29][30][31]. The results of these studies are mixed, but several of them suggest an association between elevated basal FSH levels and fetal aneuploidy that might not be predicted by age alone [23,24,26,30].…”

Section: Discussionmentioning

confidence: 99%

Maternal antimullerian hormone levels do not predict fetal aneuploidy

Plante

Beamon

Schmitt

et al. 2010

J Assist Reprod Genet

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Purpose To determine if diminished ovarian reserve (measured by maternal antimullerian hormone (AMH) levels), is associated with fetal aneuploidy (determined by prenatal karyotype). Methods This case-control study included 213 women with singleton pregnancies who underwent both serum aneuploidy screening and invasive prenatal diagnosis. 18 patients carrying an aneuploid fetus served as cases and the remaining 195 women with a euploid fetus were controls. Serum AMH was measured using two assays: AMHbc (Beckman-Coulter) and AMHdsl (Diagnostic Systems Laboratories). Karyotypes were determined by chorionic villus sampling or amniocentesis. Results AMHbc levels did not differ between women with an aneuploid fetus and women with a euploid fetus (p= 0.46) and did not predict aneuploidy (ROC Area=0.57). Additionally, AMHbc values declined significantly with advancing gestational age. Conclusions Maternal AMH does not appear to be a marker of fetal aneuploidy in ongoing pregnancies. Contrary to previous reports, we found a significant decline in maternal AMH levels with advancing gestational age.

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Elevated day 3 serum follicle stimulating hormone and/or estradiol may predict fetal aneuploidy

Cited by 129 publications

References 24 publications

A new approach to ovarian reserve testing

A new approach to ovarian reserve testing

Examining the relationship between ovarian reserve, as measured by basal FSH levels, and the risk of poor obstetric outcome in singleton IVF gestations

Maternal antimullerian hormone levels do not predict fetal aneuploidy

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