Performance of basal follicle-stimulating hormone in the prediction of poor ovarian response and failure to become pregnant after in vitro fertilization: A meta-analysis

László F.J.M.M. Bancsi, Frank J.M. Broekmans, Ben W.J. Mol, J. Dik F. Habbema, Egbert R. Te Velde

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166 Citations (Scopus)


Objective: To assess the predictive performance and clinical value of basal FSH as a test for ovarian reserve in in vitro fertilization (IVF) patients. Design: Meta-analysis. Setting: Tertiary fertility center. Patient(s): Patients undergoing IVF. Intervention(s): None. Main Outcome Measure(s): Poor ovarian response, nonpregnancy. Result(s): We located 21 studies that had reported on basal FSH and IVF outcome. No single study met high standards of methodological rigor; most studies are of moderate methodological quality only. The summary receiver operating characteristic curve indicated a moderate predictive performance for poor response, and a low predictive performance for nonpregnancy. Predictions with a substantial shift from pre-FSH-test probability to post-FSH test probability are only achieved at extreme cut-off levels for basal FSH. Sensitivity of such cut-off levels, for both the prediction of poor response and nonpregnancy, is limited. Conclusion(s): Clinical value of testing for basal FSH is restricted to a small minority of patients. Basal FSH should not be regarded as a useful routine test for the prediction of IVF outcome. The development of better tests to assess ovarian reserve remains of importance.

Original languageEnglish
Pages (from-to)1091-1100
Number of pages10
JournalFertility and Sterility
Issue number5
Publication statusPublished - 1 May 2003


  • Basal FSH
  • IVF
  • Meta-analysis
  • Ovarian response
  • Pregnancy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

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