Development of a nomogram based on markers of ovarian reserve for the individualisation of the follicle-stimulating hormone starting dose in in vitro fertilisation cycles.
OBJECTIVE
To elaborate a nomogram based on markers of ovarian reserve for the calculation of the appropriate starting dose of follicle-stimulating hormone (FSH).


METHODS
Cohort study of infertile women.


METHODS
In vitro fertilisation (IVF) unit, University Hospital of Modena, Italy.


METHODS
Women aged 18-40 years (n = 346) and undergoing their first IVF cycle.


METHODS
Serum FSH and anti-Müllerian hormone (AMH) measurement.


METHODS
Development of a model for the prediction of ovarian response to FSH.


RESULTS
A model based on age, AMH and FSH was able to accurately predict the ovarian sensitivity and accounted for 30% of the variability of ovarian response to FSH. An FSH dosage nomogram was constructed and overall it predicts a starting FSH dose <225 IU in 55.1 and 25.9% of women younger and older than 35 years, respectively.


CONCLUSIONS
In the present study we clearly demonstrated that the daily FSH dose may be calculated on the basis of a woman's age and two markers of ovarian reserve, namely AMH and FSH, with the first two vari;s (age and AMH) being the most significant predictors. The nomogram we developed seems easily applicable for clinicians during their daily clinical practice.
Mother-Infant Department, Institute of Obstetrics and Gynaecology, University of Modena and Reggio Emilia, Modena, Italy. antlamarca@libero.it
A
A
La Marca
E
E
Papaleo
V
V
Grisendi
C
C
Argento
S
S
Giulini
A
A
Volpe
D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000188:drug therapy*; D049451:Nomograms; D010062:Ovulation Induction / Q000379:methods; D011446:Prospective Studies; D055815:Young Adult
D015415:Biomarkers; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone