Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec;95(12):1333-1344.
doi: 10.1111/aogs.13032.

Individualized follicle-stimulating hormone dosing and in vitro fertilization outcome in agonist downregulated cycles: a systematic review

Theodora C van Tilborg  1 , Frank J M Broekmans  1 , Madeleine Dólleman  1 , Marinus J C Eijkemans  2 , Ben Willem Mol  3 , Joop S E Laven  4 , Helen L Torrance  1
Affiliations
Free article

Individualized follicle-stimulating hormone dosing and in vitro fertilization outcome in agonist downregulated cycles: a systematic review

Theodora C van Tilborg et al. Acta Obstet Gynecol Scand. 2016 Dec.
Free article

Abstract

Introduction: This systematic review examines whether individualized gonadotropin dosing in in vitro fertilization (IVF) leads to better outcomes with respect to safety, costs, and live birth rates compared with standard dosing.

Material and methods: Electronic databases searched were PubMed, Embase, and Cochrane. The primary outcome was live birth rate. The secondary outcomes included pregnancy rate, costs, and safety. Papers were critically appraised by two reviewers.

Results: A total of 7022 articles were retrieved and assessed for eligibility, of which seven randomized controlled trials were selected. All studies used gonadotropin-releasing hormone agonist co-treatment. Clinical and methodological heterogeneity was present, so data could not be pooled for meta-analysis. Only one study, that mainly included women with a good prognosis, revealed an increased chance of ongoing pregnancy in the individualized dosing group compared with standard treatment. With respect to safety, individualized dosing might reduce the occurrence of hyper-response and ovarian hyperstimulation syndrome, without affecting the outcome of pregnancy. In predicted poor responders, higher than standard dosages do not reduce the incidence of poor response. A cost-efficacy analysis was not performed in any of the studies included.

Conclusion: It is currently not possible to conclude whether individualized dosing leads to higher pregnancy or live birth rates compared with standard dosing, because evidence from well-designed studies that are adequately powered for one of these outcomes is lacking. So, large well-designed studies that evaluate the impact of individualized dosing on live birth rates are needed to assess whether individualized dosing should become the standard in IVF practice.

Keywords: Anti-Müllerian hormone; assisted reproduction; infertility; pregnancy; reproductive endocrinology.

PubMed Disclaimer

Publication types

Substances

LinkOut - more resources