RESEARCH QUESTION: How does the efficacy and safety of individualized follitropin delta dosing compare with conventional dosing for ovarian stimulation in potential high responders? DESIGN: Retrospective analysis of 153 potential high responders identified on the basis of baseline serum anti-Müllerian hormone (AMH) levels above 35 pmol/l, who were originally randomized to an individualized fixed dose of follitropin delta based on AMH and body weight (n = 78) or to a daily starting dose of 150 IU follitropin alfa (n = 75). RESULTS: At the end of stimulation, patients treated with individualized follitropin delta or conventional follitropin alfa had 12.1 ± 7.0 and 18.3 ± 7.0 (P < 0.001) follicles measuring 12 mm or wider, and 27.3% and 62.7% had serum progesterone levels higher than 3.18 nmol/l (P < 0.001), respectively. Overall number of oocytes in these two respective arms was 9.3 ± 6.7 and 17.9 ± 8.7 (P < 0.001), and the ongoing pregnancy rate per started cycle after fresh blastocyst transfer was 28.2% and 24.0%. The risk of ovarian hyperstimulation syndrome (OHSS) for all cases was three times higher in the conventional follitropin alfa arm at 16.0% versus 5.1% with individualized follitropin delta treatment (P = 0.025) and 26.7% versus 7.7% (P = 0.001) for early moderate or severe OHSS, preventive interventions for early OHSS, or both. CONCLUSIONS: Treatment with individualized follitropin delta provides an improved efficacy-safety balance in women with high ovarian reserve, as it normalizes the ovarian response and decreases the risk of OHSS without compromising the chance of pregnancy.

Ferring Pharmaceuticals Global Biometrics Kay Fiskers Plads 11 Copenhagen DK 2300 Denmark

Ferring Pharmaceuticals Reproductive Medicine and Maternal Health Kay Fiskers Plads 11 Copenhagen DK 2300 Denmark

Ginemed Calle Farmaceutico Murillo Herrera 3 Sevilla 41010 Spain

IRCCS San Raffaele Hospital Via Olgettina 60 Milan 20132

IVF Cube Fertility Clinic Evropská 423 Prague 160 00 Czech Republic

Ovum Fertility Clinic Bociania 13 Warsaw 02 807 Poland

Reprod Biomed Online. 2022 Sep;45(3):625. doi: 10.1016/j.rbmo.2022.03.025. PubMed

Reprod Biomed Online. 2022 Sep;45(3):623-624. doi: 10.1016/j.rbmo.2022.03.034. PubMed

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