Will increasing the dose of follicle stimulating hormone affect the outcome in assisted reproduction?

This paper studied the effect of different amounts of recombinant human follicle stimulating hormone in patients undergoing assisted reproduction. 

Ovarian stimulation is a technique where medications are used to stimulate the release of eggs in assisted reproduction. Recombinant human follicle-stimulating hormone is a man-made hormone that regulates reproduction. To date, recombinant human follicle-stimulating hormone has not been extensively studied in humans.

The interaction of follicle-stimulating hormone of anti-mullerian hormone (substance that is produced by the ovaries) was also studied, as this is an indicator of ovarian reserve (how many eggs are available in the ovaries). Studies have previously shown that women with higher anti-mullerian hormone levels tend to have more eggs retrieved.  

222 patients received one of the five doses of recombinant human follicle stimulating hormone. Patients were undergoing in-vitro fertilisation or intracytoplasmic sperm injection treatment (procedure to inject sperm into egg).

As the dose of follicle stimulating hormone increased, the average duration of ovarian stimulation decreased. The average number of eggs retrieved was 5.2 in women receiving 5.2µg of follicle stimulating hormone and 12.2 in patients receiving 12.1 µg of follicle stimulating hormone. A 10% increase in dose resulted in a 0.5 increase in eggs retrieved among women with low anti-mullerian hormone levels. A 10% increase in dose resulted in a 1.0 increase in eggs retrieved among women with high anti-mullerian hormone levels.

The fertilization rate decreased significantly as dose of follicle stimulating hormone increased. There was no association between dosage of follicle stimulating hormone and pregnancy rate.

There were 5 cases of ovarian hyperstimulation syndrome (enlarged ovaries). These occurred among women receiving the high doses of follicle stimulating hormone and or high levels of anti-mullerian hormone. 

The authors concluded that increasing the dosage of recombinant follicle stimulating hormone results in greater numbers of eggs retrieved. However, they further suggested that the dose most appropriate may be dependent on the initial anti-mullarian hormone level in the woman, and so called for a more individualised approach to artificial reproduction methods.