Objective: To elaborate a nomogram based on markers of ovarian reserve for the calculation of the appropriate starting dose of follicle-stimulating hormone (FSH).
Design: Cohort study of infertile women.
Setting: In vitro fertilisation (IVF) unit, University Hospital of Modena, Italy.
Population: Women aged 18-40 years (n = 346) and undergoing their first IVF cycle.
Methods: Serum FSH and anti-Müllerian hormone (AMH) measurement.
Main outcome measures: 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.
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.