REVIEW   

Minerva Ginecologica 2017 June;69(3):250-8

DOI: 10.23736/S0026-4784.17.04044-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Individualization of controlled ovarian stimulation in vitro fertilization using ovarian reserve markers

Valentina GRISENDI, Antonio, La MARCA ✉

Unit of Obstetrics and Gynecology, Mother-Infant Department, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy

INTRODUCTION: In assisted reproduction technologies (ART) the controlled ovarian stimulation (COS) therapy is the starting point from which a good oocytes retrieval depends. Treatment individualization is based on ovarian response prediction, which largely depends on a woman’s ovarian reserve. Anti-Müllerian hormone (AMH) and antral follicle count (AFC) are considered the most accurate and reliable markers of ovarian reserve.
EVIDENCE ACQUISITION: A literature search was carried out for studies that addressed the ability of AMH and AFC to predict poor and/or excessive ovarian response in IVF cycles.
EVIDENCE SYNTHESIS: According to the predicted response to ovarian stimulation (poor- normal- or high-response) is today possible not only to personalize pre-treatment counseling with the couple, but also to individualize the ovarian stimulation protocol, choosing among GnRH-agonists or antagonists for endogenous follicle-stimulating hormone (FSH) suppression and formulating the FSH starting dose most adequate for the single patients.
CONCLUSIONS: In this review we discuss how to choose the best COS therapy for the single patient, on the basis of the markers-guided ovarian response prediction.

KEY WORDS: Fertilization in vitro - Ovulation induction - Anti-Mullerian hormone