Can Elevated Levels of Basal Follicle Stimulating Hormone Predict a Decrease in Fertility in Young Women Undergoing ART Cycles?

An appropriate clinical evaluation and a proper treatment of women are essential for a positive outcome of assisted reproductive technology (ART) cycles. In order to obtain good results it is necessary to assess ovarian reserve before planning treatment. The determination of ovarian reserve by measuring day 3 basal FSH among normal cycling women is one of the most commonly used tests for predicting success in IVF treatment [1]. Several studies have reported that women with an elevated FSH level have poor response to ovarian stimulation that leads to a lower pregnancy rate in ART regardless their age [2]. However, other authors argued that young age does not protect against the adverse effects of reduced ovarian reserve. They also suggest that an elevated basal FSH is associated with poor quality oocytes leading to reduction in pregnancy rate and in miscarriage rates [3,4]. Recently, some studies have shown that women with higher basal FSH levels especially younger women can still achieve reasonable pregnancy rates with ART [5-7]. Therefore, the question to be raised is whether an elevated basal FSH level should be used as an entrance criterion to discourage patient’s access to treatment with ARTs.