Predictive value of basal follicle-stimulating hormone concentrations in a general subfertility population

Objective: To assess the predictive value of elevated basal FSH concentrations during the initial subfertility workup with respect to fecundity in a general subfertility population with ovulatory menstrual cycles. Design: Nested case-control study. Setting: Fertility center of a university hospital. Patient(s): Fifty subfertile women with basal FSH levels >10.0 IU/L and 50 age-matched controls. Intervention(s): Long-term follow-up (3-7 years). Main Outcome Measure(s): Pregnancies, deliveries, and time to pregnancy. Result(s): Patients with elevated basal FSH levels and controls were comparable with regard to basic characteristics, clinical diagnoses, and subfertility treatment. Long-term follow-up showed that 52% of the women with elevated basal FSH concentrations became pregnant (positive predictive value 48%) versus 62% of the controls, and 42% versus 46% eventually delivered a child, respectively. The mean time to pregnancy was 3.0 years in the elevated-FSH group and 3.4 years in controls. Most of the pregnancies in both groups occurred after spontaneous conceptions. Conclusion(s): The results of this study suggest that screening for elevated basal FSH concentrations is of no additional value in a general subfertility population with ovulatory menstrual cycles. (Fertil Steril(R) 2000;74: 97-103. (C) 2000 by American Society for Reproductive Medicine.)