The significance of elevated FSH for reproductive function.

1. Women aged 40 or more with favourable hormone profiles can do well in assisted reproduction, while women of any age with basal FSH levels greater than 20 IU/litre will be poor responders to ovarian stimulation. 2. Basal FSH is an important predictor of ovarian reserve--levels over 25 IU/litre are rarely associated with ongoing pregnancy, and the best chance for pregnancy is an FSH between 10 and 20 IU/litre. 3. A basal E2 over about 50 pg/ml predicts poor ovarian reserve. 4. Age remains an important factor even when the FSH and E2 levels are known. 5. Optimal prediction involves simultaneous consideration of age, FSH, LH and E2. 6. Provocative tests of ovarian reserve are probably superior but are not as simple as static tests. 7. Defined risks of multiple pregnancy can be controlled by adjusting the number of pre-embryos transferred according to age and FSH levels. 8. Cases of otherwise unexplained infertility may be uncovered by evaluating basal FSH and E2 levels.