Validation of a prediction model for the follicle-stimulating hormone response dose in women with polycystic ovary syndrome.
OBJECTIVE
To validate a published model for the prediction of the individual FSH response dose for gonadotropin induction of ovulation in polycystic ovary syndrome (PCOS).


METHODS
Structured, complete, and carefully monitored patient-based data collection to test the external validity of the prediction model.


METHODS
Twenty-nine hospitals in The Netherlands.


METHODS
Eighty-five clomiphene citrate (CC)-resistant women with PCOS.


METHODS
Ovulation induction in a chronic low-dose step-up FSH regimen.


METHODS
Predicted individual FSH response dose, defined as follicle growth >10 mm in diameter on ultrasound.


RESULTS
The model, using the women's body mass index, CC response, initial serum FSH level, and initial serum insulin-to-glucose ratio was studied in the validation sample. Overall, the FSH response dose predicted by the model was higher than the observed response dose. The predictive performance of the model was poor, with an R(2) of 0.11, and the average prediction error was 35 IU.


CONCLUSIONS
The external validity of the model predicting the individual FSH response dose was inadequate in women with CC-resistant PCOS undergoing ovulation induction with recombinant FSH in a low-dose step-up regimen.
van Wely
Madelon
M
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.vanwely@amc.uva.nl <m.vanwely@amc.uva.nl>
Fauser
Bart C J M
BC
Laven
Joop S E
JS
Eijkemans
Marinus J
MJ
van der Veen
Fulco
F
D000328:Adult; D000465:Algorithms; D003198:Computer Simulation; D004360:Drug Therapy, Computer-Assisted / Q000379:methods*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control*; D008954:Models, Biological; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D016896:Treatment Outcome
D005640:Follicle Stimulating Hormone