Dose adjustment of follicle-stimulating hormone (FSH) during ovarian stimulation as part of medically-assisted reproduction in clinical studies: a systematic review covering 10 years (2007-2017)

Individualization of the follicle-stimulating hormone (FSH) starting dose is considered standard clinical practice during controlled ovarian stimulation (COS) in patients undergoing assisted reproductive technology (ART) treatment. Furthermore, the gonadotropin dose is regularly adjusted during COS...

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Published in:Reproductive biology and endocrinology 2021-05, Vol.19 (1), p.68-68, Article 68
Main Authors: Fatemi, Human, Bilger, Wilma, Denis, Deborah, Griesinger, Georg, La Marca, Antonio, Longobardi, Salvatore, Mahony, Mary, Yin, Xiaoyan, D'Hooghe, Thomas
Format: Article
Language:English
Subjects:
Biomarkers
Birth rate
Clinical medicine
Clinical trials
Controlled ovarian stimulation (COS)
Follicle-stimulating hormone
Follicle-stimulating hormone (FSH)
Follicles
Follitropin
FSH dose adjustment
Gonadotropins
In vitro fertilization
In vitro fertilization (IVF)
Ovaries
Ovulation
Patients
Pituitary (anterior)
Recombinant-human FSH
Reproductive technologies
Review
Systematic review
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Summary:Individualization of the follicle-stimulating hormone (FSH) starting dose is considered standard clinical practice during controlled ovarian stimulation (COS) in patients undergoing assisted reproductive technology (ART) treatment. Furthermore, the gonadotropin dose is regularly adjusted during COS to avoid hyper- or hypo-ovarian response, but limited data are currently available to characterize such adjustments. This review describes the frequency and direction (increase/decrease) of recombinant-human FSH (r-hFSH) dose adjustment reported in clinical trials. We evaluated the proportion of patients undergoing ART treatment who received ≥ 1 r-hFSH dose adjustments. The inclusion criteria included studies (published Sept 2007 to Sept 2017) in women receiving ART treatment that allowed dose adjustment within the study protocol and that reported ≥ 1 dose adjustments of r-hFSH; studies not allowing/reporting dose adjustment were excluded. Data on study design, dose adjustment and patient characteristics were extracted. Point-incidence estimates were calculated per study and overall based on pooled number of cycles with dose adjustment across studies. The Clopper-Pearson method was used to calculate 95% confidence intervals (CI) for incidence where adjustment occurred in
ISSN:1477-7827
1477-7827
DOI:10.1186/s12958-021-00744-x