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MINERVA GINECOLOGICA

A Journal on Obstetrics and Gynecology


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Minerva Ginecologica 2017 Mar 07

DOI: 10.23736/S0026-4784.17.04044-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers

Valentina GRISENDI, Antonio La MARCA

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


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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. AMH and 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 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: IVF - COS - Individualization - AMH - AFC

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antlamarca@libero.it