FSH Requirements for Follicle Growth During Controlled Ovarian Stimulation
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. Single c...
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| Published in | Frontiers in endocrinology (Lausanne) Vol. 10; p. 579 |
|---|---|
| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Switzerland
Frontiers Media S.A
27.08.2019
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1664-2392 1664-2392 |
| DOI | 10.3389/fendo.2019.00579 |
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| Abstract | 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.
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.
Starting rFSH dose adjusted for body weight (iU/kg) predicted serum FSH level after 5 days of rFSH (
= 0.352,
< 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 (
= 0.58-0.62;
< 0.0001), and hence time to oocyte maturation trigger (
= 0.22,
< 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.
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. |
|---|---|
| AbstractList | 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 (r 2 = 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 (r 2 = 0.58-0.62; p < 0.0001), and hence time to oocyte maturation trigger (r 2 = 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.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 (r 2 = 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 (r 2 = 0.58-0.62; p < 0.0001), and hence time to oocyte maturation trigger (r 2 = 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. 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. 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 ( r 2 = 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 ( r 2 = 0.58–0.62; p < 0.0001), and hence time to oocyte maturation trigger ( r 2 = 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. 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. 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. Starting rFSH dose adjusted for body weight (iU/kg) predicted serum FSH level after 5 days of rFSH ( = 0.352, < 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 ( = 0.58-0.62; < 0.0001), and hence time to oocyte maturation trigger ( = 0.22, < 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. 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. |
| Author | Abbara, Ali Patel, Aaran Eng, Pei Chia Salim, Rehan Kelsey, Tom W. Clarke, Sophie A. Dhillo, Waljit S. Trew, Geoffrey H. Lavery, Stuart Hunjan, Tia Rai, Raj S. Comninos, Alexander N. Phylactou, Maria Chia, Germaine |
| AuthorAffiliation | 2 IVF Unit, Hammersmith Hospital, Imperial College Healthcare NHS Trust , London , United Kingdom 3 School of Computer Science, University of St Andrews , St Andrews , United Kingdom 1 Section of Endocrinology and Investigative Medicine, Imperial College London, Hammersmith Hospital , London , United Kingdom |
| AuthorAffiliation_xml | – name: 3 School of Computer Science, University of St Andrews , St Andrews , United Kingdom – name: 2 IVF Unit, Hammersmith Hospital, Imperial College Healthcare NHS Trust , London , United Kingdom – name: 1 Section of Endocrinology and Investigative Medicine, Imperial College London, Hammersmith Hospital , London , United Kingdom |
| Author_xml | – sequence: 1 givenname: Ali surname: Abbara fullname: Abbara, Ali – sequence: 2 givenname: Aaran surname: Patel fullname: Patel, Aaran – sequence: 3 givenname: Tia surname: Hunjan fullname: Hunjan, Tia – sequence: 4 givenname: Sophie A. surname: Clarke fullname: Clarke, Sophie A. – sequence: 5 givenname: Germaine surname: Chia fullname: Chia, Germaine – sequence: 6 givenname: Pei Chia surname: Eng fullname: Eng, Pei Chia – sequence: 7 givenname: Maria surname: Phylactou fullname: Phylactou, Maria – sequence: 8 givenname: Alexander N. surname: Comninos fullname: Comninos, Alexander N. – sequence: 9 givenname: Stuart surname: Lavery fullname: Lavery, Stuart – sequence: 10 givenname: Geoffrey H. surname: Trew fullname: Trew, Geoffrey H. – sequence: 11 givenname: Rehan surname: Salim fullname: Salim, Rehan – sequence: 12 givenname: Raj S. surname: Rai fullname: Rai, Raj S. – sequence: 13 givenname: Tom W. surname: Kelsey fullname: Kelsey, Tom W. – sequence: 14 givenname: Waljit S. surname: Dhillo fullname: Dhillo, Waljit S. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31507532$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.3389/fendo.2018.00193 10.1016/j.fertnstert.2015.01.004 10.1093/humupd/6.4.307 10.1530/REP-17-0697 10.1093/humrep/dew184 10.1185/030079906X104678 10.1016/J.RBMO.2017.03.004 10.1210/jc.83.4.1292 10.1093/humrep/deq361 10.1111/cen.12864 10.1093/humrep/der479 10.1093/humupd/dms041 10.1093/humrep/der092 10.1093/humrep/dex012 10.1016/J.FERTNSTERT.2014.08.013 10.2147/DDDT.S104104 10.1016/J.FERTNSTERT.2013.12.026 10.1002/14651858.CD005070.pub3 10.1016/J.EJOGRB.2016.10.021 10.1016/j.rbmo.2014.11.013 10.1186/1757-2215-6-11 10.1093/humrep/dex318 10.1016/S1472-6483(11)60012-6 10.1093/humrep/dex319 10.1016/j.fertnstert.2016.02.005 10.1016/J.FERTNSTERT.2016.10.033 10.1093/humrep/dex253 10.1111/cen.13569 10.1210/er.2017-00236 10.1016/S1472-6483(10)62135-9 10.3389/fendo.2018.00461 10.1172/JCI75730 10.1210/jc.2015-2332 10.1210/er.2005-0015 10.1093/humrep/deg019 10.3389/fendo.2018.00589 10.1016/J.RBMO.2017.09.011 10.1093/oxfordjournals.humrep.a137060 10.1002/14651858.CD012693.pub2 10.1093/humrep/deh663 10.1016/J.RBMO.2017.01.012 |
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| Copyright | Copyright © 2019 Abbara, Patel, Hunjan, Clarke, Chia, Eng, Phylactou, Comninos, Lavery, Trew, Salim, Rai, Kelsey and Dhillo. 2019 Abbara, Patel, Hunjan, Clarke, Chia, Eng, Phylactou, Comninos, Lavery, Trew, Salim, Rai, Kelsey and Dhillo |
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| Keywords | follicle growth recombinant FSH fertility in vitro fertilization (IVF) ovarian response reproduction |
| Language | English |
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| Title | FSH Requirements for Follicle Growth During Controlled Ovarian Stimulation |
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