Follicular and endocrine dose responses according to anti-Müllerian hormone levels in IVF patients treated with a novel human recombinant FSH (FE 999049)

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SummaryObjectiveTo study the association between serum anti-Müllerian hormone (AMH) levels and follicular development and endocrine responses induced by increasing doses (5·2–12·1μg/day) of a novel recombinant human FSH (rhFSH, FE 999049) in patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in a GnRH antagonist protocol.DesignSecondary analysis of a randomized controlled trial with stratified randomization according to AMH (lower stratum: 5·0–14·9 pmol/l; higher stratum: 15·0–44·9 pmol/l).PatientsInfertile women of good prognosis (n = 265).MeasurementsFollicular development and endocrine parameters during controlled ovarian stimulation (COS) with rhFSH.ResultsSerum FSH levels increased with increasing rhFSH doses and steady-state levels for each dose were similar in both AMH strata. In the whole study population, significant (P < 0·001) positive dose responses were observed for the number of follicles ≥12 mm, and serum levels of oestradiol, inhibin B, inhibin A and progesterone at end of stimulation. In comparison with the higher AMH stratum, patients in the lower AMH stratum had significantly different slopes of the dose–response curves for these hormones, and no clear dose-related increase was observed for the number of follicles in these patients.ConclusionsDose–response relationships between rhFSH and follicular development and endocrine parameters are significantly different for IVF/ICSI patients with lower and higher serum AMH levels at start of COS.

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