title: The use of ovarian reserve markers in IVF clinical practice: a national consensus.
abstract: Ovarian reserve markers have been documented to perform very well in the clinical practice. While this is widely recognized, still now there is no consensus on how to use new biomarkers in the clinical practice. This study was conducted among Italian IVF centres using the Delphi technique, a validated consensus-building process. Briefly three consecutive questionnaires were developed for clinicians in charge of IVF centres. In the first rounds, participants were asked to rate the importance of a list of statements regarding the categorization of ovarian response and the diagnostic role of biomarkers. In round 3, participants were asked to rate their agreement and consensus on the list of statements derived from the first two rounds. There were 120 respondents. Consensus was achieved for many points: (a) poor ovarian response is predicted on the basis of the following: AMH < 1 ng/ml or AFC < 7, FSH ≥ 10 IU/l, age ≥ 40 yrs; (b) hyper-response is predicted on the basis of the following: AMH > 3 ng/ml or AFC > 14; (c) day 3 FSH measurement should always be associated to estradiol; (d) AMH can be measured on a random basis; (e) the measurement of the AFC with the 2D technology may be considered adequate and (f) the AFC should be measured in the early follicular phase and consists in the total number of 2-9 mm follicles in both the ovaries. The present study suggests that extensive consensus on the importance and use of new ovarian reserve markers to improve IVF safety and performance is already present among clinicians.
authors.affiliation: a Mother-Infant Department , University of Modena and Reggio Emilia , Modena , Italy .
authors.forename: Antonio
authors.initials: A
authors.lastname: La Marca
authors.affiliation: b SISMeR, Società Italiana Studi di Medicina della Riproduzione , Bologna , Italy .
authors.forename: Anna Pia
authors.initials: AP
authors.lastname: Ferraretti
authors.affiliation: c Unità di Procreazione Medicalmente Assistita, Centro A.M.B.R.A. , Palermo , Italy , and.
authors.forename: Roberto
authors.initials: R
authors.lastname: Palermo
authors.affiliation: d Centro G.EN.E.R.A. - Clinica Valle Giulia , Roma , Italy.
authors.forename: Filippo M
authors.initials: FM
authors.lastname: Ubaldi
mesh_terms: D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers; D003697:Delphi Technique; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood*; D005498:Follicular Phase / Q000097:blood; D006801:Humans; D007558:Italy; D006080:Ovarian Follicle / Q000000981:diagnostic imaging*; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood*; D065851:Ovarian Reserve; D010062:Ovulation Induction / Q000379:methods*; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D004958:Estradiol; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone
keywords: Delphi method; infertility; ovarian reserve markers; ovarian response prediction; questionnaires