Chicago Coalition for Family Building Prognosis-Based Scoring

Medical criteria for prognosis-based scoring of in vitro fertilization grant applicants



AMH = anti-Mullerian hormone
FSH = follicle stimulating hormone
BMI = body mass index
* Autologous cycle applicants excluded for age ≥ 42 years, AMH < 0.5 ng/dL, FSH > 15mIU/mL or ≥ 3 prior failed fresh IVF cycles
* Applicants excluded for BMI > 40 kg/m2
* Applicants excluded for ≥ 20 week size uterus, submucosal fibroids, intramural fibroids ≥ 5 cm, or severe Asherman's syndrome
* A normal uterus and uterine cavity with absence of pathology receives the full 5 points and points are deducted based on severity of adhesions and fibroid burden.
* Semen analysis is scored based on volume, concentration motility and morphology.