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. 2012 Sep;119(10):1171-9.
doi: 10.1111/j.1471-0528.2012.03412.x. Epub 2012 Jul 17.

Development of a nomogram based on markers of ovarian reserve for the individualisation of the follicle-stimulating hormone starting dose in in vitro fertilisation cycles

A La Marca  1 , E Papaleo, V Grisendi, C Argento, S Giulini, A Volpe
Affiliations

Development of a nomogram based on markers of ovarian reserve for the individualisation of the follicle-stimulating hormone starting dose in in vitro fertilisation cycles

A La Marca et al. BJOG. 2012 Sep.

Abstract

Objective: To elaborate a nomogram based on markers of ovarian reserve for the calculation of the appropriate starting dose of follicle-stimulating hormone (FSH).

Design: Cohort study of infertile women.

Setting: In vitro fertilisation (IVF) unit, University Hospital of Modena, Italy.

Population: Women aged 18-40 years (n = 346) and undergoing their first IVF cycle.

Methods: Serum FSH and anti-Müllerian hormone (AMH) measurement.

Main outcome measures: Development of a model for the prediction of ovarian response to FSH.

Results: A model based on age, AMH and FSH was able to accurately predict the ovarian sensitivity and accounted for 30% of the variability of ovarian response to FSH. An FSH dosage nomogram was constructed and overall it predicts a starting FSH dose <225 IU in 55.1 and 25.9% of women younger and older than 35 years, respectively.

Conclusions: In the present study we clearly demonstrated that the daily FSH dose may be calculated on the basis of a woman's age and two markers of ovarian reserve, namely AMH and FSH, with the first two vari;s (age and AMH) being the most significant predictors. The nomogram we developed seems easily applicable for clinicians during their daily clinical practice.

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