title: Selective use of corifollitropin for controlled ovarian stimulation for IVF in patients with low anti-Müllerian hormone.
abstract: Corifollitropin, a long-acting follicle-stimulating hormone (FSH) analogue used for in vitro fertilization (IVF), does not allow individualization of dosage, and the ovarian response is similar to around 300 IU of daily recombinant FSH. This has raised concerns about the risk of ovarian hyperstimulation syndrome (OHSS) when used in standard patients. We administered corifollitropin selectively to patients with anticipated low to moderate ovarian response based on antimüllerian hormone levels in the lower quartile. The end points were oocyte distribution and occurrence of OHSS in women with AMH  ≤15 pmol/L. The study included a cohort of 368 patients treated in 599 cycles. Post hoc the cohort was subdivided according to AMH. With increasing baseline AMH, the number of oocytes increased from a mean of 2.7 (range 0-8 with AMH  <3 pmol/L) to 6.3 (range 0-15 with AMH 10-15 pmol/L) oocytes. Cancellations of retrievals and transfers decreased significantly with increasing AMH. Overall, the ongoing live pregnancy rate per started cycle was 15.2%. None developed OHSS. No cycles were cancelled or needed triggering of ovulation using a GnRH agonist due to risk of OHSS. Selective use of corifollitropin in patients with AMH in the lower quartile is a safe and appropriate way of optimising stimulation.
authors.affiliation: a Department of Gynecology and Obstetrics , The Fertility Clinic, Rigshospitalet, Copenhagen University Hospital , Copenhagen , Denmark.
authors.forename: Anna Pors
authors.initials: AP
authors.lastname: Nielsen
authors.affiliation: a Department of Gynecology and Obstetrics , The Fertility Clinic, Rigshospitalet, Copenhagen University Hospital , Copenhagen , Denmark.
authors.forename: Anne-Sofie
authors.initials: AS
authors.lastname: Korsholm
authors.affiliation: a Department of Gynecology and Obstetrics , The Fertility Clinic, Rigshospitalet, Copenhagen University Hospital , Copenhagen , Denmark.
authors.forename: Josephine G
authors.initials: JG
authors.lastname: Lemmen
authors.affiliation: a Department of Gynecology and Obstetrics , The Fertility Clinic, Rigshospitalet, Copenhagen University Hospital , Copenhagen , Denmark.
authors.forename: Randi
authors.initials: R
authors.lastname: Sylvest
authors.affiliation: a Department of Gynecology and Obstetrics , The Fertility Clinic, Rigshospitalet, Copenhagen University Hospital , Copenhagen , Denmark.
authors.forename: Negjyp
authors.initials: N
authors.lastname: Sopa
authors.affiliation: a Department of Gynecology and Obstetrics , The Fertility Clinic, Rigshospitalet, Copenhagen University Hospital , Copenhagen , Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Nyboe Andersen
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D043373:Follicle Stimulating Hormone, Human / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000139:chemically induced; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome
chemical_list: D043373:Follicle Stimulating Hormone, Human; C437186:follicle stimulating hormone, human, with HCG C-terminal peptide; D054304:Anti-Mullerian Hormone
keywords: AMH; IVF; controlled ovarian stimulation; corifollitropin