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IVF Clinical

Corrigendum: Letter to the Editor: Individualized FSH dosing improves safety and reduces iatrogenic poor response while maintaining live-birth rates

By : Prof. Dr. Human Fatemi Prof. Dr. Barbara Lawrenz, PhD Dr. Laura Melado Vidales Dr. Carol Coughlan Antonio La Marca1 * Christophe Blockeel2 Ernesto Bosch3 Renato Fanchin4 Bart C. Fauser6 Juan A. García-Velasco7 Peter Humaidan8 Basil C. Tarlatzis9

We read with interest the trials published by the OPTIMIST trial group(Oudshoorn, et al., 2017, van Tilborg, et al., 2017, van Tilborg, et al., 2017). These three papers collectively suggest that the individualization of FSH   dosing according to a baseline antral follicle count is not effective. We are concerned  that  this  conclusion  is  driven  by excessive  reliance on  live-birth  rates,  rather  than outcomes which are directly modifiable by ovarian stimulation. Recognition of non-inferiority for live -birth rates, but the distinct advantages of fewer poor responses and improved patient safety with respect to a reduced risk of ovarian hyperstimulation syndrome (OHSS) have been reportedin other  trials  examining  individualization  of  ovarian  stimulation(Allegra,  et  al.,  2017,  Nyboe Andersen, et al., 2017). We would suggest that the data from the OPTIMIST trials in fact confirms the benefits of individualized FSH   dosing, and it is notable that these advantages were achieved despite  the  very  limited  stratification  of  doses  (100,  150,  225  and  450IU)  that  were initially assessed.