Waiting for an elevated FSH--too late a marker of reduced ovarian reserve?
| Autor: | Robert Wardrop, Ee Mun Lim, Bronwyn G. A. Stuckey, Kalani Mudhitha Kahapola Arachchige, Narelle Hadlow |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
endocrine system medicine.medical_specialty Percentile Adolescent media_common.quotation_subject Fertility Fsh levels Basal (phylogenetics) Young Adult Internal medicine medicine Retrospective analysis Humans Ovarian reserve Child media_common Aged Ovarian Function Tests Retrospective Studies Aged 80 and over business.industry Ovary Age Factors Obstetrics and Gynecology Infant General Medicine Middle Aged Elevated FSH Endocrinology Child Preschool Female Follicle Stimulating Hormone business hormones hormone substitutes and hormone antagonists Biomarkers Hormone |
| Zdroj: | The AustralianNew Zealand journal of obstetricsgynaecology. 52(5) |
| ISSN: | 1479-828X |
| Popis: | To assess age at which median follicle-stimulating hormone (FSH) is elevated above 10 U/L.Fertility and ovarian reserve decrease over the 4th decade with evidence that sensitive markers such as anti-Mullerian hormone fall even earlier. Despite its limitations, a basal or day 2-3 FSH is commonly used to assess ovarian reserve with levels over 10 U/L often used as a cut-point for further investigations.Women referred to a community laboratory for 'hormone testing', including FSH and oestradiol (n = 40 254), were included in a retrospective analysis. Cases excluded were those with suppressed FSH (1 U/L) who were likely on the oral contraceptive pill or pregnant and those with increased oestradiol (500 pmol/L) who were likely approaching mid-cycle or pregnant. Remaining cases (n = 32 445) were analysed in five-year age bands for FSH median, mean, and 2.5 and 97.5 percentiles.Median FSH remained consistently low (≤5 U/L) in women ≤35 years of age and was 6 U/L in 35- to 40-year-olds. The mean FSH and 97.5 percentile increased steadily. The 97.5th percentile was 10 U/L or lower in women up to 30 years of age.Follicle-stimulating hormone is a late indicator of known reducing ovarian reserve, and in this study, median FSH did not increase over 10 U/L until45 years of age. FSH levels9 U/L were above the 97.5th percentile in those25 years of age. If fertility is a concern, FSH levels persistently above age-specific medians in women under 40 years may prompt earlier follow-up with more sensitive tests for ovarian reserve. |
| Databáze: | OpenAIRE |
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