{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:43:26Z","timestamp":1792089806981,"version":"4.4.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aims to create and validate a clinical prediction model to determine the optimal gonadotropin (Gn) starting dose in controlled ovarian stimulation (COS) protocols for normal ovarian response (NOR) patients undergoing their first IVF\/ICSI-ET cycle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted based on the data of the first IVF\/ICSI-ET cycles of 535 patients from the Reproductive Medicine Department of the Fourth Hospital of Hebei Medical University between January 2017 and June 2024. The patients were randomly divided into a training group (n=317) and a validation group (n=218) in a 6:4 ratio. Linear regression analysis was applied to screen out the potential factors influencing the Gn starting dose, and the statistically significant factors were selected to construct a nomogram for Gn dosage. We used an internal verification method to ensure the reliability of the nomogram.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patient\u2019s age, body mass index (BMI), basal follicle-stimulating hormone (bFSH), antral follicle count (AFC), and anti-M\u00fcllerian hormone (AMH) were predictive indicators of the Gn starting dose for NOR patients undergoing IVF\/ICSI-ET treatment (<jats:italic>P<\/jats:italic>&amp;lt;0.05). A predictive model was created based on the above indicators. Finally, the accuracy of this predictive model was validated by comparing the actual Gn starting doses with the predicted doses in both the training and the validation group. The results showed no significant difference between the actual and predicted Gn starting doses in the two groups (<jats:italic>P<\/jats:italic>&amp;gt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on age, BMI, bFSH, AMH, and AFC, a clinician could determine the patient\u2019s appropriate Gn starting dose for NOR patients undergoing IVF\/ICSI-ET.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1600936","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T04:10:36Z","timestamp":1750651836000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A retrospective study: establishment and validation of the prediction model for the gonadotropin starting dose in IVF\/ICSI-ET among normal ovarian response women"],"prefix":"10.3389","volume":"16","author":[{"given":"Yindi","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.18632\/aging.203032","article-title":"Machine-intelligence for developing a potent signature to predict ovarian response to tailor assisted reproduction technology","volume":"13","author":"Yan","year":"2021","journal-title":"Aging (Albany Ny.)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.4274\/jtgga.2017.0058","article-title":"How to personalize ovarian stimulation in clinical practice","volume":"18","author":"Sighinolfi","year":"2017","journal-title":"J Turk Ger Gynecol Assoc"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-021-00744-x","article-title":"Dose adjustment of follicle-stimulating hormone (fsh) during ovarian stimulation as part of medically-assisted reproduction in clinical studies: a systematic review covering 10 years (2007\u20132017)","volume":"19","author":"Fatemi","year":"2021","journal-title":"Reprod Biol Endocrinol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S1472-6483(11)60012-6","article-title":"Individualizing fsh dose for assisted reproduction using a novel algorithm: the consort study","author":"Olivennes","year":"2011","journal-title":"Reprod BioMed Online"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmp036","article-title":"Anti-mullerian hormone (amh) as a predictive marker in assisted reproductive technology (art)","volume":"16","author":"La Marca","year":"2010","journal-title":"Hum Reprod Update"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.688654","article-title":"A novel nomogram for individualized gonadotropin starting dose in gnrh antagonist protocol","volume":"12","author":"Li","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"hoaa9","DOI":"10.1093\/hropen\/hoaa009","article-title":"Eshre guideline: ovarian stimulation for ivf\/icsi(\u2020)","volume":"2020","author":"Ovarian Stimulation","year":"2020","journal-title":"Hum Reprod Open"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-019-05156-2","article-title":"A predictive formula for selecting individual fsh starting dose based on ovarian reserve markers in ivf\/icsi cycles","volume":"300","author":"Zhu","year":"2019","journal-title":"Arch Gynecol Obstet"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1185\/030079906X104678","article-title":"Predictive factors and a corresponding treatment algorithm for controlled ovarian stimulation in patients treated with recombinant human follicle stimulating hormone (follitropin alfa) during assisted reproduction technology (art) procedures. An analysis of 1378 patients","volume":"22","author":"Howles","year":"2006","journal-title":"Curr Med Res Opin"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.10.021","article-title":"Clinical application of a nomogram based on age, serum fsh and amh to select the fsh starting dose in ivf\/icsi cycles: a retrospective two-centres study","volume":"207","author":"Papaleo","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deg181","article-title":"A prospective study of predictive factors of ovarian response in \u2018standard\u2019 ivf\/icsi patients treated with recombinant fsh. A suggestion for a recombinant fsh dosage normogram","volume":"18","author":"Popovic-Todorovic","year":"2003","journal-title":"Hum Reprod"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03412.x","article-title":"Development of a nomogram based on markers of ovarian reserve for the individualisation of the follicle-stimulating hormone starting dose inin vitro fertilisation cycles","volume":"119","author":"La Marca","year":"2012","journal-title":"Bjog: Int J Obstetrics Gynaecology"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.5653\/cerm.2016.43.2.112","article-title":"Nomogram to predict the number of oocytes retrieved in controlled ovarian stimulation","volume":"43","author":"Moon","year":"2016","journal-title":"Clin Exp Reprod Med"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2022.07.010","article-title":"An interpretable machine learning model for individualized gonadotrophin starting dose selection during ovarian stimulation","volume":"45","author":"Fanton","year":"2022","journal-title":"Reprod BioMed Online"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.07.1151","article-title":"Gonadotropin dose is negatively correlated with live birth rate: analysis of more than 650,000 assisted reproductive technology cycles","volume":"104","author":"Baker","year":"2015","journal-title":"Fertil Steril"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmq041","article-title":"Clinical outcomes in relation to the daily dose of recombinant follicle-stimulating hormone for ovarian stimulation in in vitro fertilization in presumed normal responders younger than 39 years: a meta-analysis","volume":"17","author":"Sterrenburg","year":"2011","journal-title":"Hum Reprod Update"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-023-02582-2","article-title":"Dose nomogram of individualization of the initial follicle-stimulating hormone dosage for patients with polycystic ovary syndrome undergoing ivf\/icsi with the gnrh-ant protocol: a retrospective cohort study","volume":"40","author":"Si","year":"2023","journal-title":"Adv Ther"},{"key":"B18","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1186\/s12905-023-02327-x","article-title":"Nomogram to predict fsh starting dose in poor ovarian response women in progestin primed ovarian stimulation protocol","volume":"23","author":"Wu","year":"2023","journal-title":"BMC Womens Health"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e2436157","DOI":"10.1001\/jamanetworkopen.2024.36157","article-title":"Preconception and early-pregnancy body mass index in women and men, time to pregnancy, and risk of miscarriage","volume":"7","author":"Boxem","year":"2024","journal-title":"JAMA Netw Open"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14785","article-title":"Female infertility in the era of obesity: the clash of two pandemics or inevitable consequence","volume":"98","author":"Medenica","year":"2023","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B21","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s12978-018-0481-z","article-title":"The correlation between raised body mass index and assisted reproductive treatment outcomes: a systematic review and meta-analysis of the evidence","volume":"15","author":"Supramaniam","year":"2018","journal-title":"Reprod Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1093\/humupd\/dmr039","article-title":"Ovarian antral folliculogenesis during the human menstrual cycle: a review","volume":"18","author":"Baerwald","year":"2012","journal-title":"Hum Reprod Update"},{"key":"B23","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12958-015-0103-3","article-title":"Anti-mullerian hormone as a predictor of ovarian reserve in art protocols: the hidden role of thyroid autoimmunity","volume":"13","author":"Magri","year":"2015","journal-title":"Reprod Biol Endocrinol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa513","article-title":"Anti-m\u00fcllerian hormone and ovarian reserve: update on assessing ovarian function","volume":"105","author":"Moolhuijsen","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"B25","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1093\/humupd\/dmu062","article-title":"Technical and performance characteristics of anti-m\u00fcllerian hormone and antral follicle count as biomarkers of ovarian response","volume":"21","author":"Iliodromiti","year":"2015","journal-title":"Hum Reprod Update"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1210\/endo.140.12.7204","article-title":"Control of primordial follicle recruitment by anti-m\u00fcllerian hormone in the mouse ovary","volume":"140","author":"Durlinger","year":"1999","journal-title":"Endocrinology"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1600936\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T04:10:37Z","timestamp":1750651837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1600936\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,23]]},"references-count":26,"alternative-id":["10.3389\/fendo.2025.1600936"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1600936","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,23]]},"article-number":"1600936"}}