Ovarian hyperstimulation syndrome prevention strategies: individualizing gonadotropin dose. 2010

François Olivennes
IVF center Eylau La Muette, Paris, France. francois.olivennes@gmail.com

The choice of the gonadotropin starting dose is an important parameter to prevent the onset of ovarian hyperstimulation syndrome (OHSS). The vast majority of studies available propose decreasing the gonadotropin starting dose, but conflicting results confirm that simply reducing the dose is not sufficient to prevent OHSS. True and dependable individualization of the gonadotropin starting dose is not yet possible. Attempts have been made to select parameters that predict ovarian response and to model them in a scoring system or algorithm that would result in a recommended gonadotropin starting dose. The CONSORT (CONsistency in r-FSH Starting dOses for individualized tReatmenT) dosing algorithm individualizes recombinant human follicle-stimulating hormone doses for assisted reproduction technologies, assigning 37.5-IU increments according to easily available patient characteristics (basal follicle-stimulating hormone, body mass index, age, and antral follicle count) that have been proven to accurately predict ovarian response to ovarian stimulation. The use of the CONSORT algorithm achieved an adequate oocyte yield and good pregnancy rates in a preliminary study. Results of a prospective randomized study are awaited to see if this tool would allow individualization of the gonadotropin starting dose.

UI MeSH Term Description Entries
D010062 Ovulation Induction Techniques for the artifical induction of ovulation, the rupture of the follicle and release of the ovum. Ovarian Stimulation,Ovarian Stimulations,Stimulation, Ovarian,Stimulations, Ovarian
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005260 Female Females
D006062 Gonadotropins Hormones that stimulate gonadal functions such as GAMETOGENESIS and sex steroid hormone production in the OVARY and the TESTIS. Major gonadotropins are glycoproteins produced primarily by the adenohypophysis (GONADOTROPINS, PITUITARY) and the placenta (CHORIONIC GONADOTROPIN). In some species, pituitary PROLACTIN and PLACENTAL LACTOGEN exert some luteotropic activities. Gonadotropin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016471 Ovarian Hyperstimulation Syndrome A complication of OVULATION INDUCTION in infertility treatment. It is graded by the severity of symptoms which include OVARY enlargement, multiple OVARIAN FOLLICLES; OVARIAN CYSTS; ASCITES; and generalized EDEMA. The full-blown syndrome may lead to RENAL FAILURE, respiratory distress, and even DEATH. Increased capillary permeability is caused by the vasoactive substances, such as VASCULAR ENDOTHELIAL GROWTH FACTORS, secreted by the overly-stimulated OVARIES. Ovarian Hyperstimulation Syndrome, Familial Gestational Spontaneous,Hyperstimulation Syndrome, Ovarian,Hyperstimulation Syndromes, Ovarian,Ovarian Hyperstimulation Syndromes
D054796 Drug Dosage Calculations Math calculations done for preparing appropriate doses of medicines, taking into account conversions of WEIGHTS AND MEASURES. Mistakes are one of the sources of MEDICATION ERRORS. Pharmaceutical Arithmetic,Pharmaceutical Calculations,Arithmetic, Pharmaceutical,Calculation, Drug Dosage,Calculation, Pharmaceutical,Calculations, Drug Dosage,Calculations, Pharmaceutical,Dosage Calculation, Drug,Dosage Calculations, Drug,Drug Dosage Calculation,Pharmaceutical Calculation
D057285 Precision Medicine Clinical, therapeutic and diagnostic approaches to optimal disease management based on individual variations in a patient's genetic profile. Individualized Medicine,Predictive Medicine,P Health,P-Health,Personalized Medicine,Theranostics,Medicine, Individualized,Medicine, Personalized,Medicine, Precision,Medicine, Predictive,Theranostic

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