TY - JOUR
T1 - Increased gonadotrophin stimulation does not improve IVF outcomes in patients with predicted poor ovarian reserve
AU - Lekamge, Dharmawijaya N.
AU - Lane, Michelle
AU - Gilchrist, Robert B.
AU - Tremellen, Kelton P.
PY - 2008/10/30
Y1 - 2008/10/30
N2 - Purpose: This retrospective study was carried out to evaluate whether increasing the starting dose of FSH stimulation above the standard dose of 150 IU/day in patients with low predicted ovarian reserve can improve IVF outcomes. Method: A total of 122 women aged less than 36 years in their first cycle of IVF were identified as having likely low ovarian reserve based on a serum AMH measurement below 14 pmol/l. Thirty five women were administered the standard dose of 150 IU/day FSH, while the remaining 87 received a higher starting dose (200-300 IU/day FSH). There were no significant differences in age, BMI, antral follicle count, serum AMH, FSH or aetiology of infertility between the two dose groups. Results: No significant improvement in oocyte and embryo yield or pregnancy rates was observed following an upward adjustment of FSH starting dose. While increasing the dose of FSH above 150 IU/day did not produce any adverse events such as OHSS, it did consume an extra 1,100 IU of FSH per IVF cycle. Conclusion: The upward FSH dose adjustment in anticipation of low ovarian reserve can not be advocated as it is both expensive and of no proven clinical value.
AB - Purpose: This retrospective study was carried out to evaluate whether increasing the starting dose of FSH stimulation above the standard dose of 150 IU/day in patients with low predicted ovarian reserve can improve IVF outcomes. Method: A total of 122 women aged less than 36 years in their first cycle of IVF were identified as having likely low ovarian reserve based on a serum AMH measurement below 14 pmol/l. Thirty five women were administered the standard dose of 150 IU/day FSH, while the remaining 87 received a higher starting dose (200-300 IU/day FSH). There were no significant differences in age, BMI, antral follicle count, serum AMH, FSH or aetiology of infertility between the two dose groups. Results: No significant improvement in oocyte and embryo yield or pregnancy rates was observed following an upward adjustment of FSH starting dose. While increasing the dose of FSH above 150 IU/day did not produce any adverse events such as OHSS, it did consume an extra 1,100 IU of FSH per IVF cycle. Conclusion: The upward FSH dose adjustment in anticipation of low ovarian reserve can not be advocated as it is both expensive and of no proven clinical value.
KW - Anti-Müllerian hormone
KW - FSH dose adjustment
KW - IVF
KW - Predicted poor ovarian reserve controlled ovarian hyper-stimulation
UR - http://www.scopus.com/inward/record.url?scp=57349103075&partnerID=8YFLogxK
U2 - 10.1007/s10815-008-9266-6
DO - 10.1007/s10815-008-9266-6
M3 - Article
C2 - 18972201
AN - SCOPUS:57349103075
SN - 1058-0468
VL - 25
SP - 515
EP - 521
JO - Journal of Assisted Reproduction and Genetics
JF - Journal of Assisted Reproduction and Genetics
ER -