IVF center Eylau La Muette, Paris, France.
Semin Reprod Med. 2010 Nov;28(6):463-7. doi: 10.1055/s-0030-1265672. Epub 2010 Nov 16.
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.
促性腺激素起始剂量的选择是预防卵巢过度刺激综合征（OHSS）发生的一个重要参数。现有的绝大多数研究都提出降低促性腺激素起始剂量，但相互矛盾的结果证实，单纯减少剂量不足以预防 OHSS。目前还无法真正可靠地确定促性腺激素起始剂量。人们已经尝试选择预测卵巢反应的参数，并将其建模为评分系统或算法，从而得出推荐的促性腺激素起始剂量。CONSORT（CONsistency in r-FSH Starting dOses for individualized tReatmenT）剂量算法用于辅助生殖技术中的重组人卵泡刺激素剂量个体化，根据已被证明可准确预测卵巢对卵巢刺激反应的易于获得的患者特征（基础卵泡刺激素、体重指数、年龄和窦卵泡计数）分配 37.5-IU 的增量。在一项初步研究中，使用 CONSORT 算法实现了足够的卵母细胞产量和良好的妊娠率。正在等待前瞻性随机研究的结果，以确定该工具是否能够实现促性腺激素起始剂量的个体化。
