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Type: Journal article
Title: Increased gonadotrophin stimulation does not improve IVF outcomes in patients with predicted poor ovarian reserve
Author: Lekamge, D.
Lane, M.
Gilchrist, R.
Tremellen, K.
Citation: Journal of Assisted Reproduction and Genetics, 2008; 25(11-12):515-521
Publisher: Kluwer Academic/Plenum Publ
Issue Date: 2008
ISSN: 1058-0468
Statement of
Dharmawijaya N Lekamge, Michelle Lane, Robert B Gilchrist and Kelton P Tremellen
Abstract: 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.
Keywords: Anti-Müllerian hormone; Predicted poor ovarian reserve controlled ovarian hyper-stimulation; FSH dose adjustment; IVF
Description: The original publication can be found at
RMID: 0020083762
DOI: 10.1007/s10815-008-9266-6
Appears in Collections:Obstetrics and Gynaecology publications

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