Human Reproduction, Vol. 11, No. 7, pp. 1393-1398, 1996
© 1996 European Society of Human Reproduction and Embryology
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Endocrinology: Ovarian reserve test with the gonadotrophin-releasing hormone agonist buserelin: correlation with in-vitro fertilization outcome
1Service d'Endocnnologie, Hôipital Lapeyrome 2Service de Gynécologie-Obstétrique, Hôpital A.de Villeneuve 3Department d'Information Médicale, Hôipital Lapeyrome 4Laboratoire de Fécondation In Vitro, Hôpital A de Villeneuve 34295 Montpellier Cedex 5, France
Correspondence: 5To whom correspondence should be addressed
A gonadotrophin-releasing hormone agonist stimulation test determination of follicle stimulating hormone (FSH) concentrations before and 2 h after buserelin injection was carried out in 78 in-vitro fertilization cycles, and compared ith basal FSH concentrations to predict ovarian response. Ovarian response was quantified by the ratio of peak oestradiol concentration divided by the total dose of human menopausal gonadotrophin (HMG) administered, the most reproducible parameter in 11 patients who underwent two treatment cycles. Stimulation outcome was highly related to the buserelin test, the best prognostic Indicator being the sum of FSH concentrations. However, basal FSH con centration achieved similar correlations, even in those patients aged >35 years. Sensitivity, specificity, positive and negative predictive values of basal FSH concentration and sum of FSH concentrations were similar. Low basal concentration and sum of FSH concentrations were both associated with a better ovarian response. Construction of receiver operating characteristic curves demonstrated that basal FSH concentration was more informative than the sum of FSH concentrations. Finally, the sum of FSH concentrations did not increase the prediction of ovarian response variability. We conclude that the buserelin test is strongly predictive of stimulation outcome, but is no more informative than the usual screening. We suggest that the performance of other stimulation tests should be clearly compared with that of basal FSH concentration.
Key words: FSH/GnRH agonistr/in-vitro fertilization/ovarian reserve/ovarian stimulation
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