The prognostic value of age and follicle-stimulating hormone levels in women over forty years of age undergoing in vitro fertilization.

Purpose: Basal follicle-stimulating hormone (FSH) and ageare predictors of successful outcome in in vitro fertilization(IVF). More recently, the clomiphene citrate challenge test(CCCT) has been proposed as a better way to predict IVFoutcome than FSH alone. The purpose of this study was todetermine which indicator of ovarian reserve—basal(day 3) FSH or the CCCT—is the better predictor of IVF successin the critical age group of women over the age of 40. Methods: In this retrospective study, basal FSH andclomiphene-stimulated FSH levels from 104 women whounderwent 175 cycles of IVF were analyzed. Results: Neither basal FSH level nor stimulated FSH levelalone were statistically significant predictors of IVF success;however, no patient with a day 3 FSH level >11.1 mIU/mlor a stimulated day 10 FSH level >13.5 mIU/ml conceivedand carried a pregnancy. All ongoing pregnancies occurredin the first two cycles of IVF. Conclusions: Clear prognostic cutoff values were found topredict IVF success in women over age 40. IVF programsshould consider limiting the number of cycles of IVF inwomen above age 40.