The gonadotropins starting dose calculator, which can be adjusted the target number of oocytes and stimulation duration days to achieve individualized controlled ovarian stimulation in Japanese patients

Abstract

Purpose To create a gonadotropin starting dose calculator for controlled ovarian stimulation, which can adjust the target number of oocytes and stimulation duration for each facility to achieve individualized controlled ovarian stimulation among the Japanese patients. Methods The patients received controlled ovarian stimulation using the gonadotropin‐releasing hormone antagonist protocol, and oocytes were retrieved. Using single regression analysis, we selected age, anti‐Müllerian hormone (AMH), and initial serum follicle‐stimulating hormone as variables to predict the number of oocytes retrieved per gonadotropin dose (oocyte sensitivity index). Each variable was then analyzed using backward stepwise multiple regression. Results Age and AMH were selected as predictive variables from the backward stepwise multiple regression, and we developed a multiple regression equation. We decomposed the equation as the number of oocytes retrieved/(gonadotropin starting dose × stimulation duration days) and created a calculation formula to predict the gonadotropin starting dose from the target number of oocytes and stimulation duration days. Conclusions This is the first study to develop an individualized dosing algorithm for gonadotropins among Japanese patients. Our calculator will improve controlled ovarian stimulation performance and enable national standardization by allowing all physicians, regardless of their years of experience, to determine the appropriate starting dose of gonadotropins equally.

Age-related change in AMH in women seeking fertility – a hospital-based study across India

“…9 With an increase in female age, the size of the pool of the remaining microscopic follicles decreases. 10,11 AMH level starts a log-linear decline approximately 15 years before menopause and drops to a very low level before menopause. 12 Instructively, the physiology of female fertility explains the diminishing number and quality of oocytes with increasing age.…”