The Association Between Gonadotropin Dosage and Oocyte Retrieval Outcomes in in-vitro fertilization (IVF) Cycles

Background/Aim: To assess the relationship between Gonadotropin dosage and IVF outcomes, aiming to determine the optimal dosage for maximizing the IVF outcomes. Materials and Methods: A detailed analysis was undertaken on 53,764 stimulation cycles conducted between January 2009 and May 2024. The primary endpoints encompassed the number of oocytes retrieved and secondary outcome was the number of blastocysts. Key parameters evaluated included the dosage of Gonadotropin, serum FSH concentrations stratified by patient age (<35, 35-40 and ≤40) and AMH categories (<1, 1-3 and 3≤). Results: The analysis showed that increased total gonadotropin dosages affected the number of oocytes retrieved and blastocysts formed. Optimal outcomes were observed within the range of 2,000–3,000 IU, while efficacy decreased beyond this threshold. Patients with higher ovarian reserve needed lower dosages to reach the peak. Pre-trigger serum FSH levels of 15–20 mIU/ml were identified as beneficial for patients with robust ovarian reserve, and levels of 20–25 mIU/ml for those with low ovarian reserve. It was noted that the dosage and serum FSH levels optimized for blastocyst formation were lower than those required to maximize oocyte retrieval. Conclusions: Gonadotropin dosage and serum FSH beyond a threshold offers limited benefit. Individualized stimulation strategies considering age, AMH, and serum FSH levels are recommended for optimizing outcomes.