A prospective study of predictive factors of ovarian response in 'standard' IVF/ICSI patients treated with recombinant FSH. A suggestion for a recombinant FSH dosage normogram.
BACKGROUND
The aim was to identify independent predictors of ovarian response to recombinant (r)FSH through a multiple regression analysis.


METHODS
Prospective study including 145 'standard' patients treated with 150 IU/day of rFSH during their first IVF/ICSI cycle. Down-regulation was achieved with long agonist protocol. The following were examined as possible predictive factors: age, body mass index, cycle length, smoking status and on day 2-5: total ovarian volume, total number of antral follicles (<10 mm), total Doppler score of the ovarian stromal blood flow, serum FSH, LH, estradiol, inhibin B, and testosterone.


RESULTS
Total number of antral follicles, total Doppler score, serum FSH, LH, estradiol, inhibin B, smoking status and cycle length were independent predictors of the number of aspirated follicles. The number of oocytes was predicted by the total number of antral follicles, total Doppler score, serum testosterone and smoking status. In bivariate linear regression analyses ovarian volume was a highly significant predictor of both the number of follicles (P < 0.001) and the number of oocytes (P < 0.001).


CONCLUSIONS
Among 12 investigated possible predictive factors in 'standard' patients, the total number of antral follicles and ovarian stromal blood flow assessed by total Power Doppler score are the two most significant predictors of ovarian response. Suggestion for an rFSH dosage normogram is presented.
Popovic-Todorovic
B
B
The Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark. drbiba@yahoo.com
Loft
A
A
Lindhard
A
A
Bangsbøll
S
S
Andersson
A M
AM
Andersen
A Nyboe
AN
D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D007247:Infertility, Female / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006080:Ovarian Follicle / Q000473:pathology; D010053:Ovary / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage*; D012039:Regional Blood Flow; D012212:Rheology; D020554:Sperm Injections, Intracytoplasmic; D014463:Ultrasonography
D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone