Predicting the FSH threshold dose in women with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate
Identifieur interne : 000570 ( Istex/Corpus ); précédent : 000569; suivant : 000571Predicting the FSH threshold dose in women with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate
Auteurs : Anders Nyboe Andersen ; Adam Balen ; Peter Platteau ; Paul Devroey ; Lisbeth Helmgaard ; Joan-Carles ArceSource :
- Human Reproduction [ 0268-1161 ] ; 2008-06.
Abstract
BACKGROUND The objective of this investigation was to establish independent predictors of follicle-stimulating hormone (FSH) threshold dose in anovulatory women undergoing ovulation induction with FSH preparations. METHODS One hundred and fifty-one patients with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate underwent ovarian stimulation with FSH-only preparations following a low-dose step-up protocol. The individual FSH threshold dose was defined as the FSH dose when meeting the human chorionic gonadotrophin criteria (one follicle 17 mm, or 23 follicles 15 mm). The influence of demographics, physical characteristics, obstetric and infertility and menstrual cycle history, ovarian ultrasonography, endocrine parameters and type of gonadotrophin preparation on the FSH threshold dose was assessed through multiple regression analysis. RESULTS In the univariate analysis, age, body mass index (BMI), failure to ovulate with clomiphene citrate, menstrual cycle history (amenorrhea, oligomenorrhea or anovulatory cycles of 2135 days), mean ovarian volume, LH/FSH ratio, testosterone and free androgen index were significant (P < 0.05) predictors of FSH threshold dose. In the multivariate analysis, menstrual cycle history, mean ovarian volume and BMI remained significant (P < 0.001). CONCLUSIONS The individual FSH threshold dose for ovulation induction in anovulatory women can be predicted based on three variables easily determined in clinical practice: menstrual cycle history, mean ovarian volume and BMI. A FSH dosage nomogram was constructed based on these parameters.
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DOI: 10.1093/humrep/den089
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Predicting the FSH threshold dose in women with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate</title><author><name sortKey="Nyboe Andersen, Anders" sort="Nyboe Andersen, Anders" uniqKey="Nyboe Andersen A" first="Anders" last="Nyboe Andersen">Anders Nyboe Andersen</name><affiliation><mods:affiliation>Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: anyboea@rh.dk</mods:affiliation></affiliation></author><author><name sortKey="Balen, Adam" sort="Balen, Adam" uniqKey="Balen A" first="Adam" last="Balen">Adam Balen</name><affiliation><mods:affiliation>Department of Obstetrics and Gynaecology, Leeds General Infirmary, Leeds, UK</mods:affiliation></affiliation></author><author><name sortKey="Platteau, Peter" sort="Platteau, Peter" uniqKey="Platteau P" first="Peter" last="Platteau">Peter Platteau</name><affiliation><mods:affiliation>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Devroey, Paul" sort="Devroey, Paul" uniqKey="Devroey P" first="Paul" last="Devroey">Paul Devroey</name><affiliation><mods:affiliation>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Helmgaard, Lisbeth" sort="Helmgaard, Lisbeth" uniqKey="Helmgaard L" first="Lisbeth" last="Helmgaard">Lisbeth Helmgaard</name><affiliation><mods:affiliation>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark</mods:affiliation></affiliation></author><author><name sortKey="Arce, Joan Carles" sort="Arce, Joan Carles" uniqKey="Arce J" first="Joan-Carles" last="Arce">Joan-Carles Arce</name><affiliation><mods:affiliation>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:41DBB7293CD2E5E6FF19DC21AA82F02F8C3313C2</idno><date when="2008" year="2008">2008</date><idno type="doi">10.1093/humrep/den089</idno><idno type="url">https://api.istex.fr/document/41DBB7293CD2E5E6FF19DC21AA82F02F8C3313C2/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000570</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Predicting the FSH threshold dose in women with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate</title><author><name sortKey="Nyboe Andersen, Anders" sort="Nyboe Andersen, Anders" uniqKey="Nyboe Andersen A" first="Anders" last="Nyboe Andersen">Anders Nyboe Andersen</name><affiliation><mods:affiliation>Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: anyboea@rh.dk</mods:affiliation></affiliation></author><author><name sortKey="Balen, Adam" sort="Balen, Adam" uniqKey="Balen A" first="Adam" last="Balen">Adam Balen</name><affiliation><mods:affiliation>Department of Obstetrics and Gynaecology, Leeds General Infirmary, Leeds, UK</mods:affiliation></affiliation></author><author><name sortKey="Platteau, Peter" sort="Platteau, Peter" uniqKey="Platteau P" first="Peter" last="Platteau">Peter Platteau</name><affiliation><mods:affiliation>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Devroey, Paul" sort="Devroey, Paul" uniqKey="Devroey P" first="Paul" last="Devroey">Paul Devroey</name><affiliation><mods:affiliation>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium</mods:affiliation></affiliation></author><author><name sortKey="Helmgaard, Lisbeth" sort="Helmgaard, Lisbeth" uniqKey="Helmgaard L" first="Lisbeth" last="Helmgaard">Lisbeth Helmgaard</name><affiliation><mods:affiliation>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark</mods:affiliation></affiliation></author><author><name sortKey="Arce, Joan Carles" sort="Arce, Joan Carles" uniqKey="Arce J" first="Joan-Carles" last="Arce">Joan-Carles Arce</name><affiliation><mods:affiliation>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Human Reproduction</title><idno type="ISSN">0268-1161</idno><idno type="eISSN">1460-2350</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2008-06">2008-06</date><biblScope unit="volume">23</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1424">1424</biblScope><biblScope unit="page" to="1430">1430</biblScope></imprint><idno type="ISSN">0268-1161</idno></series><idno type="istex">41DBB7293CD2E5E6FF19DC21AA82F02F8C3313C2</idno><idno type="DOI">10.1093/humrep/den089</idno><idno type="ArticleID">den089</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0268-1161</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">BACKGROUND The objective of this investigation was to establish independent predictors of follicle-stimulating hormone (FSH) threshold dose in anovulatory women undergoing ovulation induction with FSH preparations. METHODS One hundred and fifty-one patients with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate underwent ovarian stimulation with FSH-only preparations following a low-dose step-up protocol. The individual FSH threshold dose was defined as the FSH dose when meeting the human chorionic gonadotrophin criteria (one follicle 17 mm, or 23 follicles 15 mm). The influence of demographics, physical characteristics, obstetric and infertility and menstrual cycle history, ovarian ultrasonography, endocrine parameters and type of gonadotrophin preparation on the FSH threshold dose was assessed through multiple regression analysis. RESULTS In the univariate analysis, age, body mass index (BMI), failure to ovulate with clomiphene citrate, menstrual cycle history (amenorrhea, oligomenorrhea or anovulatory cycles of 2135 days), mean ovarian volume, LH/FSH ratio, testosterone and free androgen index were significant (P < 0.05) predictors of FSH threshold dose. In the multivariate analysis, menstrual cycle history, mean ovarian volume and BMI remained significant (P < 0.001). CONCLUSIONS The individual FSH threshold dose for ovulation induction in anovulatory women can be predicted based on three variables easily determined in clinical practice: menstrual cycle history, mean ovarian volume and BMI. A FSH dosage nomogram was constructed based on these parameters.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>Anders Nyboe Andersen</name><affiliations><json:string>Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark</json:string><json:string>E-mail: anyboea@rh.dk</json:string></affiliations></json:item><json:item><name>Adam Balen</name><affiliations><json:string>Department of Obstetrics and Gynaecology, Leeds General Infirmary, Leeds, UK</json:string></affiliations></json:item><json:item><name>Peter Platteau</name><affiliations><json:string>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium</json:string></affiliations></json:item><json:item><name>Paul Devroey</name><affiliations><json:string>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium</json:string></affiliations></json:item><json:item><name>Lisbeth Helmgaard</name><affiliations><json:string>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark</json:string></affiliations></json:item><json:item><name>for the Bravelle Ovulation Induction (BOI) Study Group Joan-Carles Arce</name><affiliations><json:string>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>anovulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>follicle-stimulating hormone</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>threshold dose</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>predictors</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>efficiency</value></json:item></subject><articleId><json:string>den089</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>BACKGROUND The objective of this investigation was to establish independent predictors of follicle-stimulating hormone (FSH) threshold dose in anovulatory women undergoing ovulation induction with FSH preparations. METHODS One hundred and fifty-one patients with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate underwent ovarian stimulation with FSH-only preparations following a low-dose step-up protocol. The individual FSH threshold dose was defined as the FSH dose when meeting the human chorionic gonadotrophin criteria (one follicle 17 mm, or 23 follicles 15 mm). The influence of demographics, physical characteristics, obstetric and infertility and menstrual cycle history, ovarian ultrasonography, endocrine parameters and type of gonadotrophin preparation on the FSH threshold dose was assessed through multiple regression analysis. RESULTS In the univariate analysis, age, body mass index (BMI), failure to ovulate with clomiphene citrate, menstrual cycle history (amenorrhea, oligomenorrhea or anovulatory cycles of 2135 days), mean ovarian volume, LH/FSH ratio, testosterone and free androgen index were significant (P > 0.05) predictors of FSH threshold dose. In the multivariate analysis, menstrual cycle history, mean ovarian volume and BMI remained significant (P > 0.001). CONCLUSIONS The individual FSH threshold dose for ovulation induction in anovulatory women can be predicted based on three variables easily determined in clinical practice: menstrual cycle history, mean ovarian volume and BMI. A FSH dosage nomogram was constructed based on these parameters.</abstract><qualityIndicators><score>7.676</score><pdfVersion>1.2</pdfVersion><pdfPageSize>612.283 x 790.866 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1624</abstractCharCount><pdfWordCount>5188</pdfWordCount><pdfCharCount>32662</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>223</abstractWordCount></qualityIndicators><title>Predicting the FSH threshold dose in women with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate</title><genre><json:string>research-article</json:string></genre><host><volume>23</volume><publisherId><json:string>humrep</json:string></publisherId><pages><last>1430</last><first>1424</first></pages><issn><json:string>0268-1161</json:string></issn><issue>6</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1460-2350</json:string></eissn><title>Human Reproduction</title></host><categories><wos><json:string>OBSTETRICS & GYNECOLOGY</json:string><json:string>REPRODUCTIVE BIOLOGY</json:string></wos></categories><publicationDate>2008</publicationDate><copyrightDate>2008</copyrightDate><doi><json:string>10.1093/humrep/den089</json:string></doi><id>41DBB7293CD2E5E6FF19DC21AA82F02F8C3313C2</id><score>0.28612256</score><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/41DBB7293CD2E5E6FF19DC21AA82F02F8C3313C2/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/41DBB7293CD2E5E6FF19DC21AA82F02F8C3313C2/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/41DBB7293CD2E5E6FF19DC21AA82F02F8C3313C2/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Predicting the FSH threshold dose in women with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Oxford University Press</publisher><availability><p>The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissionsoxfordjournals.org</p></availability><date>2008-03-26</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Predicting the FSH threshold dose in women with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate</title><author xml:id="author-1"><persName><forename type="first">Anders</forename><surname>Nyboe Andersen</surname></persName><email>anyboea@rh.dk</email><affiliation>Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark</affiliation></author><author xml:id="author-2"><persName><forename type="first">Adam</forename><surname>Balen</surname></persName><affiliation>Department of Obstetrics and Gynaecology, Leeds General Infirmary, Leeds, UK</affiliation></author><author xml:id="author-3"><persName><forename type="first">Peter</forename><surname>Platteau</surname></persName><affiliation>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium</affiliation></author><author xml:id="author-4"><persName><forename type="first">Paul</forename><surname>Devroey</surname></persName><affiliation>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium</affiliation></author><author xml:id="author-5"><persName><forename type="first">Lisbeth</forename><surname>Helmgaard</surname></persName><affiliation>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark</affiliation></author><author xml:id="author-6"><persName><forename type="first">Joan-Carles</forename><surname>Arce</surname></persName><affiliation>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark</affiliation></author></analytic><monogr><title level="j">Human Reproduction</title><idno type="pISSN">0268-1161</idno><idno type="eISSN">1460-2350</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2008-06"></date><biblScope unit="volume">23</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1424">1424</biblScope><biblScope unit="page" to="1430">1430</biblScope></imprint></monogr><idno type="istex">41DBB7293CD2E5E6FF19DC21AA82F02F8C3313C2</idno><idno type="DOI">10.1093/humrep/den089</idno><idno type="ArticleID">den089</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2008-03-26</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>BACKGROUND The objective of this investigation was to establish independent predictors of follicle-stimulating hormone (FSH) threshold dose in anovulatory women undergoing ovulation induction with FSH preparations. METHODS One hundred and fifty-one patients with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate underwent ovarian stimulation with FSH-only preparations following a low-dose step-up protocol. The individual FSH threshold dose was defined as the FSH dose when meeting the human chorionic gonadotrophin criteria (one follicle 17 mm, or 23 follicles 15 mm). The influence of demographics, physical characteristics, obstetric and infertility and menstrual cycle history, ovarian ultrasonography, endocrine parameters and type of gonadotrophin preparation on the FSH threshold dose was assessed through multiple regression analysis. RESULTS In the univariate analysis, age, body mass index (BMI), failure to ovulate with clomiphene citrate, menstrual cycle history (amenorrhea, oligomenorrhea or anovulatory cycles of 2135 days), mean ovarian volume, LH/FSH ratio, testosterone and free androgen index were significant (P < 0.05) predictors of FSH threshold dose. In the multivariate analysis, menstrual cycle history, mean ovarian volume and BMI remained significant (P < 0.001). CONCLUSIONS The individual FSH threshold dose for ovulation induction in anovulatory women can be predicted based on three variables easily determined in clinical practice: menstrual cycle history, mean ovarian volume and BMI. A FSH dosage nomogram was constructed based on these parameters.</p></abstract><textClass><keywords scheme="keyword"><list><head>Keywords</head><item><term>anovulation</term></item><item><term>follicle-stimulating hormone</term></item><item><term>threshold dose</term></item><item><term>predictors</term></item><item><term>efficiency</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2008-03-26">Created</change><change when="2008-06">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/41DBB7293CD2E5E6FF19DC21AA82F02F8C3313C2/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="publisher-id">humrep</journal-id><journal-id journal-id-type="hwp">humrep</journal-id><journal-title>Human Reproduction</journal-title><issn pub-type="ppub">0268-1161</issn><issn pub-type="epub">1460-2350</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1093/humrep/den089</article-id><article-id pub-id-type="publisher-id">den089</article-id><article-categories><subj-group subj-group-type="heading"><subject>ORIGINAL ARTICLES</subject><subj-group><subject>Reproductive Endocrinology</subject></subj-group></subj-group></article-categories><title-group><article-title>Predicting the FSH threshold dose in women with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nyboe Andersen</surname><given-names>Anders</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="corresp" rid="cor1">5</xref></contrib><contrib contrib-type="author"><name><surname>Balen</surname><given-names>Adam</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Platteau</surname><given-names>Peter</given-names></name><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Devroey</surname><given-names>Paul</given-names></name><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Helmgaard</surname><given-names>Lisbeth</given-names></name><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Arce</surname><given-names>Joan-Carles</given-names></name><xref ref-type="aff" rid="af4">4</xref><on-behalf-of>for the Bravelle Ovulation Induction (BOI) Study Group</on-behalf-of></contrib></contrib-group><aff id="af1"><label>1</label><addr-line>Fertility Clinic, Rigshospitalet</addr-line>, <institution>Copenhagen University Hospital</institution>, <addr-line>Blegdamsvej 9, 2100 Copenhagen</addr-line>, <country>Denmark</country></aff><aff id="af2"><label>2</label><addr-line>Department of Obstetrics and Gynaecology, Leeds General Infirmary, Leeds</addr-line>, <country>UK</country></aff><aff id="af3"><label>3</label><institution>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel</institution>, <addr-line>Brussels</addr-line>, <country>Belgium</country></aff><aff id="af4"><label>4</label><addr-line>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen</addr-line>, <country>Denmark</country></aff><author-notes><corresp id="cor1"><label>5</label>Correspondence address. E-mail: <email>anyboea@rh.dk</email></corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2008</year></pub-date><pub-date pub-type="epub"><day>26</day><month>3</month><year>2008</year></pub-date><volume>23</volume><issue>6</issue><fpage>1424</fpage><lpage>1430</lpage><history><date date-type="received"><day>15</day><month>11</month><year>2007</year></date><date date-type="rev-recd"><day>13</day><month>2</month><year>2008</year></date><date date-type="accepted"><day>28</day><month>2</month><year>2008</year></date></history><copyright-statement>© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org</copyright-statement><copyright-year>2008</copyright-year><license license-type="creative-commons" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/uk/"><p>The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed: the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given: if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative word this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org</p></license><abstract><sec><title>BACKGROUND</title><p>The objective of this investigation was to establish independent predictors of follicle-stimulating hormone (FSH) threshold dose in anovulatory women undergoing ovulation induction with FSH preparations.</p></sec><sec><title>METHODS</title><p>One hundred and fifty-one patients with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate underwent ovarian stimulation with FSH-only preparations following a low-dose step-up protocol. The individual FSH threshold dose was defined as the FSH dose when meeting the human chorionic gonadotrophin criteria (one follicle ≥17 mm, or 2–3 follicles ≥15 mm). The influence of demographics, physical characteristics, obstetric and infertility and menstrual cycle history, ovarian ultrasonography, endocrine parameters and type of gonadotrophin preparation on the FSH threshold dose was assessed through multiple regression analysis.</p></sec><sec><title>RESULTS</title><p>In the univariate analysis, age, body mass index (BMI), failure to ovulate with clomiphene citrate, menstrual cycle history (amenorrhea, oligomenorrhea or anovulatory cycles of 21–35 days), mean ovarian volume, LH/FSH ratio, testosterone and free androgen index were significant (<italic>P</italic> < 0.05) predictors of FSH threshold dose. In the multivariate analysis, menstrual cycle history, mean ovarian volume and BMI remained significant (<italic>P</italic> < 0.001).</p></sec><sec><title>CONCLUSIONS</title><p>The individual FSH threshold dose for ovulation induction in anovulatory women can be predicted based on three variables easily determined in clinical practice: menstrual cycle history, mean ovarian volume and BMI. A FSH dosage nomogram was constructed based on these parameters.</p></sec></abstract><kwd-group><title>Keywords</title><kwd>anovulation</kwd><kwd>follicle-stimulating hormone</kwd><kwd>threshold dose</kwd><kwd>predictors</kwd><kwd>efficiency</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Predicting the FSH threshold dose in women with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Predicting the FSH threshold dose in women with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate</title></titleInfo><name type="personal"><namePart type="given">Anders</namePart><namePart type="family">Nyboe Andersen</namePart><affiliation>Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark</affiliation><affiliation>E-mail: anyboea@rh.dk</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Adam</namePart><namePart type="family">Balen</namePart><affiliation>Department of Obstetrics and Gynaecology, Leeds General Infirmary, Leeds, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Peter</namePart><namePart type="family">Platteau</namePart><affiliation>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Paul</namePart><namePart type="family">Devroey</namePart><affiliation>Center for Reproductive Medicine, Universitair Ziekenhuis (UZ) Brussel, Brussels, Belgium</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lisbeth</namePart><namePart type="family">Helmgaard</namePart><affiliation>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart>for the Bravelle Ovulation Induction (BOI) Study Group</namePart><namePart type="given">Joan-Carles</namePart><namePart type="family">Arce</namePart><affiliation>Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2008-06</dateIssued><dateCreated encoding="w3cdtf">2008-03-26</dateCreated><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>BACKGROUND The objective of this investigation was to establish independent predictors of follicle-stimulating hormone (FSH) threshold dose in anovulatory women undergoing ovulation induction with FSH preparations. METHODS One hundred and fifty-one patients with WHO Group II anovulatory infertility failing to ovulate or conceive on clomiphene citrate underwent ovarian stimulation with FSH-only preparations following a low-dose step-up protocol. The individual FSH threshold dose was defined as the FSH dose when meeting the human chorionic gonadotrophin criteria (one follicle 17 mm, or 23 follicles 15 mm). The influence of demographics, physical characteristics, obstetric and infertility and menstrual cycle history, ovarian ultrasonography, endocrine parameters and type of gonadotrophin preparation on the FSH threshold dose was assessed through multiple regression analysis. RESULTS In the univariate analysis, age, body mass index (BMI), failure to ovulate with clomiphene citrate, menstrual cycle history (amenorrhea, oligomenorrhea or anovulatory cycles of 2135 days), mean ovarian volume, LH/FSH ratio, testosterone and free androgen index were significant (P < 0.05) predictors of FSH threshold dose. In the multivariate analysis, menstrual cycle history, mean ovarian volume and BMI remained significant (P < 0.001). CONCLUSIONS The individual FSH threshold dose for ovulation induction in anovulatory women can be predicted based on three variables easily determined in clinical practice: menstrual cycle history, mean ovarian volume and BMI. A FSH dosage nomogram was constructed based on these parameters.</abstract><subject><genre>Keywords</genre><topic>anovulation</topic><topic>follicle-stimulating hormone</topic><topic>threshold dose</topic><topic>predictors</topic><topic>efficiency</topic></subject><relatedItem type="host"><titleInfo><title>Human Reproduction</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0268-1161</identifier><identifier type="eISSN">1460-2350</identifier><identifier type="PublisherID">humrep</identifier><identifier type="PublisherID-hwp">humrep</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>23</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>1424</start><end>1430</end></extent></part></relatedItem><identifier type="istex">41DBB7293CD2E5E6FF19DC21AA82F02F8C3313C2</identifier><identifier type="DOI">10.1093/humrep/den089</identifier><identifier type="ArticleID">den089</identifier><accessCondition type="use and reproduction" contentType="copyright">The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. 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