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Individualization of FSH Doses in Assisted Reproduction: Facts and Fiction
1University Medical Center Utrecht, Utrecht, Netherlands.
Frontiers in Endocrinology
|May 14, 2019
Summary
Optimizing ovarian stimulation in IVF requires balancing FSH dosage with other ART factors. While personalized dosing doesn't consistently improve live birth rates, it can significantly reduce OHSS risks, especially for high responders.
Area of Science:
- Reproductive Endocrinology
- In Vitro Fertilization (IVF)
- Ovarian Stimulation Protocols
Background:
- Ovarian stimulation with exogenous FSH is a critical step in IVF/ICSI.
- The goal is to maximize live birth probability by obtaining an optimal number of oocytes.
- The relationship between oocyte yield and live birth rates requires careful consideration alongside other ART components.
Purpose of the Study:
- To evaluate the effectiveness of personalized ovarian stimulation strategies in IVF/ICSI.
- To determine if individualized FSH dosing improves live birth rates and reduces OHSS risks.
- To assess the utility of ovarian reserve testing in guiding FSH dosage adjustments.
Main Methods:
- Review of studies on personalized ovarian stimulation strategies.
- Analysis of factors influencing ovarian response, including ovarian reserve tests (Antral Follicle Count, Anti-Mullerian Hormone), body weight, and previous cycle data.
- Comparison of individualized FSH dosages versus standard 150 IU dosing.
Main Results:
- Dosage individualization did not consistently improve live birth prospects.
- Significant reductions in Ovarian Hyperstimulation Syndrome (OHSS) risk were observed with dosage adjustments.
- High-dose FSH for predicted low responders showed no cost-benefit; reducing doses for predicted high responders enhanced safety.
Conclusions:
- Personalized FSH dosing in IVF/ICSI is more effective for mitigating OHSS risk than for improving live birth rates.
- Abandoning high FSH doses for predicted low responders is recommended.
- With advancements like GnRH agonist triggering and antagonist protocols, ovarian reserve testing may become less critical for managing high responders.
Keywords:
FSHOHSSdosage individualizationlive birthovarian reserve testingovarian responseovarian stimulationsafetyMore Related Videos
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