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Keywords:

  • Age;
  • anti-Müllerian hormone;
  • assisted reproductive technology;
  • follicle-stimulating hormone;
  • ovarian reserve;
  • starting follicle-stimulating hormone dose

Please cite this paper as: La Marca A, Papaleo E, Grisendi V, Argento C, Giulini S, Volpe A. Development of a nomogram based on markers of ovarian reserve for the individualisation of the follicle-stimulating hormone starting dose in in vitro fertilisation cycles. BJOG 2012;119:1171–1179.

Objective  To elaborate a nomogram based on markers of ovarian reserve for the calculation of the appropriate starting dose of follicle-stimulating hormone (FSH).

Design  Cohort study of infertile women.

Setting  In vitro fertilisation (IVF) unit, University Hospital of Modena, Italy.

Population  Women aged 18–40 years (n = 346) and undergoing their first IVF cycle.

Methods  Serum FSH and anti-Müllerian hormone (AMH) measurement.

Main outcome measures  Development of a model for the prediction of ovarian response to FSH.

Results  A model based on age, AMH and FSH was able to accurately predict the ovarian sensitivity and accounted for 30% of the variability of ovarian response to FSH. An FSH dosage nomogram was constructed and overall it predicts a starting FSH dose <225 IU in 55.1 and 25.9% of women younger and older than 35 years, respectively.

Conclusions  In the present study we clearly demonstrated that the daily FSH dose may be calculated on the basis of a woman’s age and two markers of ovarian reserve, namely AMH and FSH, with the first two vari;s (age and AMH) being the most significant predictors. The nomogram we developed seems easily applicable for clinicians during their daily clinical practice.