Individualised dosage. Women w/ anti-Müllerian hormone (AMH) <15 pmol/L
12 mcg daily, irrespective of body wt. Women w/ AMH ≥15 pmol/L
Decrease daily dose from 0.19 to 0.10 mcg/kg by increasing AMH conc. Round off the dose to the nearest 0.33 mcg to match the dosing scale on the inj pen. Max: 12 mcg/day for the 1st treatment. Initiate dosing, 2 or 3 days after menstrual bleeding started, & continue until adequate follicular development has been achieved. Inj a single dose of 250 mcg recombinant hCG or 5,000 IU hCG as soon as ≥3 follicles ≥17 mm are observed. Consider GnRH agonist instead of hCG in patients w/ excessive ovarian response at risk of ovarian hyperstimulation syndrome (OHSS). Subsequent treatment cycle: Maintain & modify daily dose according to patient's ovarian response in previous cycle. Patients who developed OHSS or were at risk of OHSS in a previous cycle
Lower daily dose used from previous cycle where OHSS or risk of OHSS occurred by 33%, for subsequent treatment cycles. Max: 24 mcg daily.