The 112.5IU r-hFSH starting dose is enough for successful IVF in AMH ≥3 ng/ml

Abstract

Controlled ovarian hyperstimulation(COH) is needed in order to improve the pregnancy rate in IVF cycles. Recently, there has been an interest in using a much lower dosage of FSH for mild stimulation in IVF protocols. The purpose of this study was to assess the mild stimulation with starting dose of recombinant human FSH (r-hFSH) 112.5IU could be enough for successful IVF outcomes in patients with AMH ≥3ng/ml in IVF cycles. Retrospective. We retrospectively reviewed 657 consecutive cycles of 594 normo-ovulatroy women(AMH ≥3ng/ml) who underwent IVF treatment over a 3-year period (2010 –2012) at our institution. Our study population was divided into two groups according to r-hFSH starting dose for COH-IVF cycles. Group A: r-hFSH(Gonal-F®) starting dose 112.5IU (n=257), Group B: starting dose 150IU (n=400) in women with AMH ≥3ng/ml. Outcomes were compared the number of oocytes retrieved, total dose of r-hFSH, total r-hFSH stimulation days, clinical pregnancy and abortion rate between the two groups.. The total dose of r-hFSH administered was significantly different between the group A and the group B (1055.1 IU and 1365.5 IU, p<0.01). The total number of r-hFSH administration days (9.6days (5–17) and 9.1days (9–16), p=0.08) and embryo quality were comparable in both groups. Although the number of retrieved oocytes (14.9 ± 6.8 vs. 13.3 ± 6.1, P<0.01) and fertilized oocytes(9.1 ± 4.9 vs. 8.8 ± 4.3, P=0.02) were significantly higher in group A than group B. However, the pregnancy rate (63.4% vs 58.3%, p=0.139) and abortion rate (12.9% vs13.3%) were not significantly different between both groups. In our results, a total mean r-hFSH dose of 1055.1IU with the 112.5IU starting dose in COH cycle was sufficient for the number of retrieved oocytes and the pregnancy rates in patients with AMH≥3ng/ml. Therefore, These seems clear that a subset of patients with AMH ≥3ng/ml undergoing ovarian stimulation can be adequately treated with a 112.5 IU starting dose of r-hFSH.