A comparative study of fixed-dose, step-down, and low-dose step-up regimens of human menopausal gonadotropin for patients with polycystic ovary syndrome

• Published in: Fertility and sterility Vol. 70; no. 5; pp. 840 - 846
• Main Authors: Andoh, Kazumichi, Mizunuma, Hideki, Liu, Xiaowei, Kamijo, Takanori, Yamada, Kiyohiko, Ibuki, Yoshito
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.11.1998; Elsevier Science
• Subjects: Adult; Analysis of Variance; Biological and medical sciences; Dose-Response Relationship, Drug; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Hormones - blood; human menopausal gonadotropin; Humans; low-dose; Medical sciences; Menotropins - therapeutic use; Ovarian Follicle - diagnostic imaging; ovulation induction; Ovulation Induction - methods; Polycystic ovary syndrome; Polycystic Ovary Syndrome - drug therapy; Pregnancy; Pregnancy Outcome; Pregnancy Tests; step-down; Tumors; Ultrasonography; step-down; Polycystic ovary syndrome; low-dose; human menopausal gonadotropin; ovulation induction; Toxicity; Stimulation; Polycystic ovary; Randomization; Cyst; Clinical trial; Female; FSH; Testicular hormone; Benign neoplasm; Ovulation inducer; HMG; Androgen; Low dose; Female sterility; Gonadotropin; HCG; Ovulation; Placental hormone; Biological activity; Female genital diseases; Ovarian diseases; Testosterone; Adenohypophyseal hormone; Sex steroid hormone; LH; Comparative study
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/S0015-0282(98)00308-2

Objective: To compare the efficacy and safety of the fixed-dose, the step-down, and the low-dose step-up regimens of hMG for women with polycystic ovary syndrome (PCOS). Design: Prospective randomized study. Setting: Gunma University School of Medicine, Maebashi, Japan. Patient(s): Thirty-seven women with PCOS. Intervention(s): The fixed-dose, the step-down, and the low-dose step-up regimens were administered. Main Outcome Measure(s): The number of growing follicles and serum hormone levels. Result(s): Serum FSH levels on the day of hCG administration were significantly higher in the fixed-dose regimen group than in the step-down and the low-dose step-up regimen groups, and the number of growing follicles (≥11 mm) in the low-dose step-up regimen group was significantly smaller than in the fixed-dose regimen group. On the 7th day after hCG administration, the maximal diameter of the ovaries in the low-dose step-up regimen group was significantly smaller than in the fixed-dose and the step-down regimen groups, and the risk of excessive ovarian enlargement (≥70 mm) was significantly lower in the low-dose step-up regimen group than in the fixed-dose regimen group. Conclusion: The low-dose step-up regimen of hMG for patients with PCOS may be the safest protocol among the three stimulation regimens for reducing multiple follicular development.