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Increased gonadotrophin stimulation does not improve IVF outcomes in patients with predicted poor ovarian reserve

  • ASSISTED REPRODUCTION
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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.

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Acknowledgements

Dharmawijaya Lekamge was supported by an International Post-Graduate Research Scholarship (IPRS) and Adelaide University Scholarship. We wish to thank staff at Repromed for friendly assistance.

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Authors and Affiliations

  1. Research Centre for Reproductive Health, Discipline of Obstetrics & Gynaecology, School of Paediatrics and Reproductive Health, University of Adelaide, 5005, Adelaide, South Australia & Repromed, 180 Fullarton Road, Dulwich, 5065, Adelaide, South Australia, Australia

    Dharmawijaya N Lekamge, Michelle Lane & Kelton P Tremellen

  2. Research Centre for Reproductive Health, Discipline of Obstetrics & Gynaecology, School of Paediatrics and Reproductive Health, 5005, Adelaide, South Australia, Australia

    Robert B Gilchrist

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  1. Dharmawijaya N Lekamge
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  2. Michelle Lane
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  4. Kelton P Tremellen
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Correspondence to Kelton P Tremellen.

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Capsule Upward FSH dose adjustment in anticipation of diminished ovarian reserve predicted by low serum anti-müllerian hormone levels does not improve IVF outcomes.

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Lekamge, D.N., Lane, M., Gilchrist, R.B. et al. Increased gonadotrophin stimulation does not improve IVF outcomes in patients with predicted poor ovarian reserve. J Assist Reprod Genet 25, 515–521 (2008). https://doi.org/10.1007/s10815-008-9266-6

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  • DOI: https://doi.org/10.1007/s10815-008-9266-6

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