Impact of gonadotrophin stimulation for assisted reproductive technology on ovarian ageing and menopause.

This study investigated whether menopausal age is inversely related to the number of assisted reproduction cycles and/or ampoules of FSH used, as an indication of the possibility that gonadotrophin treatment accelerates follicular depletion. A questionnaire addressing reproductive health, history and treatment was mailed to women who had been treated for infertility at Bourn Hall Clinic, Cambridge, between 1981 and 1994. Additional data were extracted from clinical records. Of 739 mailings, 199 responses were obtained and 101 provided full sets of data. No significant associations by multiple regression analysis were found between total number of ampoules of FSH, number of assisted reproduction cycles or pregnancies and menopausal age; the mean of about 50 years is similar to values reported in other menopause studies. No relationship was found between the severity of menopausal symptoms and the number of assisted reproduction cycles or any other covariate. The only significant relationship found was an association between number of IVF cycles and increasing menopausal age (P = 0.001); this may be due to women with later menopause being self-selected for more IVF treatment. This study provides reassuring evidence that ovarian stimulation does not compromise reproductive potential by hastening menopause, an observation consistent with experimental studies showing that primordial follicle recruitment is independent of gonadotrophin stimulation.