Patient-tailored ovarian stimulation for in vitro fertilization

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Presentation transcript:

Patient-tailored ovarian stimulation for in vitro fertilization Bart C.J.M. Fauser, M.D., Ph.D. Fertility and Sterility Volume 108, Issue 4, Pages 585-591 (October 2017) DOI: 10.1016/j.fertnstert.2017.08.016 Copyright © 2017 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Nomogram predicting chances for ovulation and live birth for clomiphene ovulation induction in women with polycystic ovary syndrome, based on initial screening characteristics such as amenorrhoea/oligomenorrhoea, body mass index (BMI), free androgen index (FAI), and age (Imani et al., 2002 [15]). CI = confidence interval. Fertility and Sterility 2017 108, 585-591DOI: (10.1016/j.fertnstert.2017.08.016) Copyright © 2017 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Receiver operating characteristic curves based on meta-analysis of individual patient data, regarding the capacity of patient characteristics to predict ovarian response to exogenous stimulation for in vitro fertilization: (A) poor response (defined as <5 oocytes retrieved) involving 28 studies and 5,705 women (Broer et al., 2013 [21]); (B) excessive response (defined as >15 oocytes retrieved) involving 57 studies and 4,786 women (Broer er al., 2013 [22]). AFC = antral follicle count; AMH = antimüllerian hormone. Fertility and Sterility 2017 108, 585-591DOI: (10.1016/j.fertnstert.2017.08.016) Copyright © 2017 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Nomogram for calculating individualized FSH starting dose based on female age and FSH and antimüllerian hormone (AMH) concentrations, subsequently tested in a randomized controlled trial compared with an age-based standard FSH dose (Allegra et al., 2017 [28]). Fertility and Sterility 2017 108, 585-591DOI: (10.1016/j.fertnstert.2017.08.016) Copyright © 2017 American Society for Reproductive Medicine Terms and Conditions

Figure 4 Data obtained from a multicenter randomized controlled trial in 1,329 women comparing individualized and conventional FSH dosing (Nyboe Andersen et al., 2017 [27]). (A) Proportion of women achieving the targeted number of oocytes (8–14), comparing both study arms in relation to antimüllerian hormone (AMH) levels. (B) Proportion of women requiring ovarian hyperstimulation syndrome (OHSS)–preventive interventions and or experiencing OHSS in relation to AMH levels. Fertility and Sterility 2017 108, 585-591DOI: (10.1016/j.fertnstert.2017.08.016) Copyright © 2017 American Society for Reproductive Medicine Terms and Conditions