Increased basal FSH levels as predictors of low-quality follicles in infertile women with endometriosis

Abstract 

Objective

To determine whether basal levels of follicle-stimulating hormone (FSH) and anti-müllerian hormone (AMH), antral follicle count (AFC), and the numbers of dominant follicles, oocytes, and mature oocytes retrieved after ovarian stimulation differed between infertile women with endometriosis and healthy women undergoing assisted reproduction techniques (ART).

Method

Of 77 consecutive ART candidates, 27 were infertile and had endometriosis. A male factor caused the infertility of the other 50, who acted as controls.

Results

The AMH and AFC levels were similar in the 2 groups. The FSH levels were higher (8.28mIU/mL [range, 5.25–24.1mIU/mL] vs 5.91mIU/mL [range, 2.47–18.7mIU/mL]; P<0.01) in the study group. And the numbers of retrieved (n=5 [range, 0–12] vs n=9 [range, 0–27; P<0.05) and mature oocytes (n=4 [range, 0–11] vs n=5 [range, 0–16]; P<0.05) were less in the study group.

Conclusion

Because AMH levels were unchanged, endometriosis seems not to damage the primordial pool of follicles and oocytes, but to lessen the quality of the ovarian response to the hCG injection. Basal FSH levels may be of value in predicting ART success in women with the disease.

Keywords: Anti-müllerian hormone, Endometriosis, Follicle stimulating hormone, Infertility, Ovarian reserve