IVF Success Rates
Practically speaking, significant hyperstimulation (OHSS) is a rare risk after age 40. Under age 40, CHR defines normal AMH levels in an age-specific way, and considers women with AMH levels over the 95% confidence interval for their age as "at risk" for hyperstimulation. CHR, however, also considers follicle-stimulating hormone (FSH) levels in the diagnosis.
The good news is that a large majority of PCOS patients will conceive with use of their own eggs.
FSH and AMH levels usually move in opposite directions: as AMH declines with advancing female age, FSH rises. In most cases, both hormones statistically relate quite well, as CHR investigators reported in a number of recent research publications.
A small group of women, however, do not follow this pattern. Women with high FSH and AMH levels recently have come to the attention of CHR investigators because high FSH levels would usually come with low AMH levels. In a recently published study, CHR investigators studied a sizable group of such women, and noted that the combination of high FSH and AMH denotes superior outcomes in IVF cycles. It appears that this combination of high FSH and high AMH results in significantly better oocyte yields and IVF pregnancy rates than all other FSH/AMH combinations.
High FSH and High AMH: What It Means for Pregnancy Chances
Dr. Gleicher presents a research finding: Women whose AMH and FSH are both high have a significantly higher pregnancy chances.
This finding may explain why the published literature is divided on whether or not PCOS negatively affects IVF pregnancy rates. These recent observations by CHR investigators further support the "basket" nature of PCOS as a diagnostic entity. They, however, also suggest a first potential tool to differentiate which type of PCOS patients have better pregnancy chances with IVF.
The good news is that a large majority of PCOS patients will conceive with use of their own eggs. To shorten time to conception and increase pregnancy chances with IVF for PCOS patients, fertility treatments in PCOS patients must be appropriately individualized to the specific phenotype of PCOS a patient has. CHR's pioneering discovery of the role of FMR1 sub-genotypes in determining oocyte yields and IVF pregnancy chances in PCOS patients, as discussed above, is one of the ways to improve success rates of fertility treatments for PCOS patients through individualization.
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Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.