Individualization of FSH Doses in Assisted Reproduction: Facts and Fiction

Conclusions For many years we have held the belief that more oocytes will produce better outcome in terms of live birth rate. The current evidence from well-designed studies has helped us to separate fiction from facts. The facts are that we need more than one oocyte, preferably a number in the range of 8–15. Below that number, but specifically below five oocytes, prognosis for live birth will become jeopardized. Oocyte numbers over 15, and specifically over 20, are undesirable in view of the risk of OHSS occurring. Low responders cannot really be prevented by applying higher than normal dosages, while high responders may benefit from FSH dosage reduction, mainly for the safety issue. So, for that latter purpose, ovarian reserve testing and subsequent dose adjustments could be justified. The high responder patient, however, may also be served by the GnRH antagonist co-medicated stimulation approach: standard dosing with 150 IU, with the option of triggering final oocyte maturation by a GnRH agonist with or without deferred embryo transfer (48–50). With these facts together, we may find that the FSH dose individualization practice may become a realm of the past. Author Contributions The author confirms being the sole contributor of this work and has approved it for publication. Conflict of Interest Statement FB receives monetary compensation: Member of the external advisory board for Ferring BV, Netherlands. Member of the external advisory board for Merck ...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research