The predictive value of basal follicle stimulating and growth hormone levels as determined by immunofluorometry during assisted reproduction.

ABSTRACT

PURPOSE: Our purpose was (a) to investigate relationships of baseline endocrine serum levels with selected assisted reproduction (AR) parameters and (b) to evaluate the clinical applicability of an immunofluorometric assay (IFMA) as an alternative to a radioimmunoassay (RIA). METHODS: Basal endocrine values (analyzed by RIA-rFSH, rLH, and rE2; analyzed by IFMA-fFSH, fLH, and fGH) were determined for female patients (n = 142) preceding ovarian stimulation for AR. RESULTS: Specific AR parameters correlated significantly with RIA- and IFMA-determined FSH levels, although IFMA correlations consistently exceeds that of RIA. Cut-off values of fFSH > or = 11.68 IU/L or rFSH > or = 15.0 IU/L indicated a poor response. The high-basal fFSH group was older (34 vs 31 years; P = 0.0334) and yielded fewer oocytes (2.9 vs 4.6 oocytes; P = 0.0018) than the low-basal fFSH group (< 11.68 IU/L). Lower cumulative embryo scores and conception rates were also associated with the high-fFSH group, compared to the low-fFSH group. CONCLUSIONS: This study confirms the negative impact of elevated basal FSH levels on AR. Basal LH, GH, and E2 levels are, in comparison to baseline FSH levels, unsuitable indices for estimating ovarian responsiveness. IFMA can be regarded as an alternative to RIA in both clinical and research laboratories.