Elevated Day 3 Serum Follicle Stimulating Hormone And/or Estradiol May Predict Fetal Aneuploidy

Objective: To determine whether baseline serum FSH and/or E2 concentrations can predict the risk for fetal chromosomal abnormalities.

Design: Case control study.

Setting: Reproductive technology program at a university hospital.

Patient(s): Patients who underwent dilation and curettage (D + C), and whose products of conception were karyotyped.

Intervention(s): Patients underwent natural conception or controlled ovarian hyperstimulation followed by intrauterine insemination, in vitro fertilization and embryo transfer, gamete intrafallopian transfer, or zygote intrafallopian transfer.

Main Outcome Measure(s): Baseline serum FSH and E2 concentrations and fetal karyotype.

Result(s): Genetic evaluation of 78 D + C specimens revealed 34 normal and 44 abnormal fetal karyotypes. A significantly greater proportion of women with abnormal fetal karyotype had elevated baseline serum FSH (> or =15 mIU/mL [RIA] or 10 mIU/mL [Immulite]) and/or E2 > or = 50 pg/mL [Immulite]) compared with women of normal fetal karyotype. Among karyotypically abnormal abortuses, autosomal trisomy was the most common abnormality noted (79.5%), followed by mosaicism (6.8%), triploidy (6.8%), monosomy XO (4.5%), and balanced translocation (2.3%).

Conclusion(s): Baseline serum FSH and/or E2 concentrations may be valuable as predictors of fetal aneuploidy.