A comparative prospective study of conventional regimen with chronic low-dose administration of follicle-stimulating hormone for anovulation associated with polycystic ovary syndrome

• Published in: Fertility and sterility Vol. 63; no. 4; pp. 729 - 733
• Main Authors: Homburg, Roy, Levy, Tally, Ben-Rafael, Zion
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1995; Elsevier Science
• Subjects: Adult; Anovulation - drug therapy; Anovulation - etiology; Biological and medical sciences; Clomiphene - therapeutic use; Dose-Response Relationship, Drug; Drug Resistance; Female; Follicle Stimulating Hormone - administration & dosage; Follicle Stimulating Hormone - adverse effects; Follicle Stimulating Hormone - therapeutic use; Genital system. Reproduction; Humans; induction of ovulation; low-dose FSH therapy; Medical sciences; Ovarian Hyperstimulation Syndrome - chemically induced; Ovulation Induction - methods; Pharmacology. Drug treatments; Polycystic ovary syndrome; Polycystic Ovary Syndrome - complications; Pregnancy; Pregnancy, Multiple; Prospective Studies; Recombinant Proteins; induction of ovulation; Polycystic ovary syndrome; low-dose FSH therapy; Human; Anovulation; Induction; Low dose; Female sterility; Gonadotropin; Polycystic ovary; Ovulation; Female genital diseases; Ovarian diseases; Chemotherapy; Chronic; Treatment; Adenohypophyseal hormone; Cyst; FSH; Benign neoplasm
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/S0015-0282(16)57473-1

To compare efficiency of conventional and chronic low-dose regimens for treatment of anovulation associated with polycystic ovary syndrome (PCOS). Fifty participants divided into two equal groups. The first group was treated with urinary human FSH using a conventional stepwise protocol and the second group was treated with a regimen of chronic low-dose and small incremental rises with urinary human FSH or with recombinant human FSH for a maximum of three cycles. Tertiary referral university hospital fertility unit. Fifty infertile women with clomiphene citrate-resistant anovulation associated with PCOS. Pattern of follicular development, amount of FSH required, serum E2 concentrations, cycle fecundity, cumulative conception, and live birth rates. Multiple pregnancy and ovarian hyperstimulation syndrome (OHSS) rates. Compared with the conventional dose protocol, the chronic low-dose regimen yielded slightly improved pregnancy rates (40% versus 24%) while completely avoiding OHSS and multiple pregnancies, which were prevalent (11% and 33%, respectively) with conventional therapy. Mono-follicular development was induced in 74% versus 27% of cycles, and the total number of follicles > 16 mm and E2 concentrations were half those observed on conventional therapy. For women with PCOS, a chronic low-dose regimen of FSH eliminated complications of OHSS and multiple pregnancies while maintaining a satisfactory pregnancy rate. This modality, thus, has distinct advantages and could well replace conventional gonadotropin therapy for these patients.