FSH requirements for follicle growth during controlled ovarian stimulation
MetadataShow full item record
Altmetrics Handle Statistics
Altmetrics DOI Statistics
Introduction: Ovarian follicle growth is a key step in the success of assisted reproductive treatment, but limited data exists to directly relate follicle growth to recombinant FSH (rFSH) dose. In this study, we aim to evaluate FSH requirements for follicular growth during controlled ovarian stimulation. Method: Single center retrospective cohort study of 1,034 IVF cycles conducted between January 2012–January 2016 at Hammersmith Hospital IVF unit, London, UK. Median follicle size after 5 days of stimulation with rFSH and the proportion of antral follicles recruited were analyzed in women treated with rFSH alone to induce follicular growth during IVF treatment. Results: Starting rFSH dose adjusted for body weight (iU/kg) predicted serum FSH level after 5 days of rFSH (r2 = 0.352, p < 0.0001), median follicle size after 5 days of rFSH, and the proportion of antral follicles recruited by the end of stimulation. Day 5 median follicle size predicted median follicle size on subsequent ultrasound scans (r2 = 0.58–0.62; p < 0.0001), and hence time to oocyte maturation trigger (r2 = 0.22, P < 0.0001). Insufficient rFSH starting dose that required >5% dose-increase was associated with increased variability in follicle size on the day of oocyte maturation trigger, and negatively impacted the number of mature oocytes retrieved. Conclusion: Weight-adjusted rFSH dose correlates with follicular growth during ovarian stimulation. Early recruitment of follicles using a sufficient dose of rFSH from the start of stimulation was associated with reduced variability in follicle size at time of oocyte maturation trigger and an increased number of mature oocytes retrieved.
Abbara , A , Patel , A H , Hunjan , T , Clarke , S , Chia , G , Eng , P C , Phylactou , M , Comninos , A , Lavery , S , Trew , G , Salim , R , Rai , R , Kelsey , T W & Dhillo , W 2019 , ' FSH requirements for follicle growth during controlled ovarian stimulation ' , Frontiers in Endocrinology , vol. 10 , 579 . https://doi.org/10.3389/fendo.2019.00579
Frontiers in Endocrinology
Copyright © 2019 Abbara, Patel, Hunjan, Clarke, Chia, Eng, Phylactou, Comninos, Lavery, Trew, Salim, Rai, Kelsey and Dhillo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
DescriptionThis paper presents independent research funded by grants from the MRC, BBSRC, and NIHR and supported by the NIHR/Wellcome Trust Imperial Clinical Research Facility and Imperial Biomedical Research Centre. The Section of Endocrinology and Investigative Medicine was funded by grants from the MRC, BBSRC, NIHR and was supported by the NIHR Biomedical Research Centre Funding Scheme. AA was supported by National Institute of Health Research (NIHR) Clinician Scientist Award CS-2018-18-ST2-002. SC was supported by funding from an NIHR Academic Clinical Lectureship. WD was supported by an NIHR Research Professorship NIHR-RP-2014-05-001. TK was supported by EPSRC EP/P015638/1. The Medical Research Council (MRC), Wellcome Trust & National Institute of Health Research (NIHR) provided research funding to carry out studies using kisspeptin.
Items in the St Andrews Research Repository are protected by copyright, with all rights reserved, unless otherwise indicated.