Scripties UMCG - Rijksuniversiteit Groningen
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Anti-Müller hormoon voorspelt de ovariële respons onvoldoende bij gecontroleerde ovariële hypersimulatie

(2018) Bosmans, F.S.

This research has explored the effect of the implementation of Anti Müllerian Hormone (AMH) in the protocol of controlled ovarium hyperstimulation (COH) to facilitate in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). AMH is believed to be a good marker for the ovarian reserves and for the ovarian response to COH. The purpose of this study is to gain knowledge about the effect of this ‘new’ protocol on treatment outcomes and especially on the risk of hyperstimulation and ovarian hyperstimulation syndrome (OHSS). In this study, patients starting their first IVF or ICSI cycle between January 1st 2015 and December 31th 2017, were included. In the first patient group the ‘old’ protocol was used. In this protocol a standard dosage of recombinant FSH (follicle stimulating hormone) was used for all patients, except for those who had extremely abnormal blood values of estradiol, LH (luteinizing hormone) or FSH. In the second patient group the ‘new’ protocol was used, in which the AMH-value determined the dosage of recombinant FSH. Analysis of treatment outcomes showed that implementation of AMH in the COH-protocol did not improve IVF or ICSI cycles. Pregnancy rates and the risk of hyperstimulation were unchanged, whereas more patients had a poor ovarian response and the numbers of oocytes and embryos were lower. AMH is a poor predictor of ovarian response in COH. Other factors, such as patients age, Body Mass Index and antral follicle count, should be considered when deciding on the recombinant FSH dosage.

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