Background: The FSH starting dose is usually chosen according to women�s age, anamnesis, clinical criteria and\r\nmarkers of ovarian reserve. Currently used markers include antral follicle count (AFC), which is considered to have a\r\nvery high performance in predicting ovarian response to FSH. The objective of the present study to elaborate a\r\nnomogram based on AFC for the calculation of the appropriate FSH starting dose in IVF cycles.\r\nMethods: This is a retrospective study performed at the Mother-Infant Department of Modena University Hospital.\r\nIVF patients (n=505) were subjected to blood sampling and transvaginal ultrasound for measurement of serum\r\nday3 FSH, estradiol and AFC. The variables predictive of the number of retrieved oocytes were assessed by\r\nbackwards stepwise multiple regression. The variables reaching the statistical significance were then used in the\r\ncalculation for the final predictive model.\r\nResults: A model based on age, AFC and FSH was able to accurately predict the ovarian sensitivity and accounted\r\nfor 30% of the variability of ovarian response to FSH. An FSH dosage nomogram was constructed and overall it\r\npredicts a starting dose lower than 225 IU in 50.2% and 18.1% of patients younger and older than 35 years,\r\nrespectively.\r\nConclusions: The daily FSH dose may be calculated on the basis of age and two markers of ovarian reserve,\r\nnamely AFC and FSH, with the last two variables being the most significant predictors. The nomogram seems easily\r\napplicable during the daily clinical practice.
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