Clinical outcomes of potential high responders after individualized FSH dosing based on anti-Müllerian hormone and body weight

Published:September 02, 2021DOI:


      • Treatment of potential high responders with individualized follitropin delta dosing:
      • Normalises the average ovarian response
      • Reduces the incidence of preovulatory progesterone rises.
      • Reduces the ovarian hyperstimulation syndrome incidence
      • Reduces preventive interventions of ovarian hyperstimulation syndrome


      Research question

      How does the efficacy and safety of individualized follitropin delta dosing compare with conventional dosing for ovarian stimulation in potential high responders?


      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).


      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.


      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.

      Graphical abstract


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      Bernadette Mannaerts, PhD, graduated in medical biology from the University of Utrecht, the Netherlands, where she obtained her PhD in ‘Innovative drug development for infertility therapy’. She is Senior Medical Science Director at Reproductive Medicine and Women's Health at Ferring's Research in Copenhagen, Denmark, leading the global infertility drug development.
      Key message
      Potential high responders defined as women with serum anti-Müllerian hormone above 35 pmol/l undergoing ovarian stimulation with individualized follitropin delta dosing have a normalized ovarian response and, therefore, a considerably lower risk of ovarian hyperstimulation syndrome without a compromised chance of pregnancy after fresh blastocyst transfer.