A comparative randomized multicentric study comparing the step-up versus step-down protocol in polycystic ovary syndrome

Christin-Maître, Sophie; Hugues, Jean‐Noël

doi:10.1093/humrep/deg336

Cited by 138 publications

(64 citation statements)

References 21 publications

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“…24 Previous studies that assessed follitropin-alfa for ovulation induction in women with CC resistant PCOS, have reported that the pregnancy rate per stimulated cycle was approximately 18-20%. 8,[25][26][27] However, the current trial revealed comparable biochemical and clinical pregnancy rates (21% and 19% respectively) upon using CC for 10 days in ovulation induction for CC resistant Patients. Furthermore, our data emphasized that the pregnancy rates of CC 10 day protocol were similar to follitropin-alfa therapy.…”

Section: Discussionmentioning

confidence: 51%

Efficacy of extended clomifene citrate regimen in comparison with gonadotropins in clomifene citrate-resistant women with polycystic ovary syndrome

Hassan

2014

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionmentioning

confidence: 51%

Efficacy of extended clomifene citrate regimen in comparison with gonadotropins in clomifene citrate-resistant women with polycystic ovary syndrome

Hassan

2014

Int J Reprod Contracept Obstet Gynecol

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“…This fact was men ti o ned be fo re in a num ber of stu di es. 11,12 Streh ler et al as ses sed 578 pa ti ents. 7 Tre atment with hu man me no po sal go na dot hro pin (hMG) was used in 282 pa ti ents, whe re as 296 pa tients we re tre a ted with r FSH.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Recombinant Versus Highly-Purified, Urinary Follicle-Stimulating Hormone (r-FSH vs. HP-uFSH) in the Polycystic Ovary Syndrom Patients who had Antagonist Cycle with In Vitro Fertilization- mbryo Transfer

Kara¹,

Kutlu²,

Sofuoǧlu³

2011

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve es s: : Although there are a number of studies on the costs and efficacy of the drugs which are used in in vitro fertilization (IVF), the data obtained in antagonist cycles of polycystic ovary syndrome (PCOS) cases are still controversial. The aim of the study was to evaluate follicular development, pregnancy outcome and cost-effectiveness comparing r-FSH and HP-u FSH in antagonist cycles of PCOS cases. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A total of 102 patients were included in the study. Patients were treated using the same stimulation protocol. r-FSH (n= 54) or HP-u FSH (n= 48) were given according to the clinician's choice and the patient's preference. R Re es su ul lt ts s: : r-FSH treatment required significantly less amount to induce follicular development and resulted in higher plasma levels of estradiol on the day of human chorionic gonadotropin (hCG) injection. Although pregnancy rate in the r FSH group was higher than HP u FSH group (40.7% vs. 33.3%), the difference was not statistically significant. Total FSH dose was significantly lower in r FSH group comparet to HP-uFSH (1396.3 ± 131.6 iu vs.1820.14 ± 174.6 iu). C Co on nc cl lu us si io on n: : r-FSH is more efficient than HP-u FSH in terms of total FSH dose. The Follicular development and endometrial thickness on the day of hCG were better in the r-FSH group, however these differences were not statistically significant. Although r-FSH is more expensive, the final treatment cost with r-FSH per pregnancy was slightly lower although this difference was not statistically significant. K Ke ey y W Wo or rd ds s: : Follicle stimulating hormone; polycystic ovary syndrome; pregnancy Ö ÖZ ZE ET T A Am ma aç ç: : İn vitro fertilizasyonun (İVF) ma li ye ti ve kul la nı lan ilaç la rın et kin li ği hak kın da da ha ön ce ya yın lan mış bir çok ça lış ma lar ol ma sı na rağ men, an ta go nist sik lus ugu la nan po li kistik overli (PKO) has ta lar dan el de edi len bil gi ler ha len tar tış ma lı dır. Bu ça lış ma nın ama cı r FSH ve HP-u FSH'nin an ta go nist sik lus ya pı lan PKO'lu has ta lar da ki fol li kül ge li şi mi, ge be lik sonuç la rı ve ma li ye te et ki si ni de ğer len dir mek ti. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Top lam 102 has ta ça lış maya da hil edil di. Has ta lar ay nı sti mü las yon yön te miy le te da vi edil di. r FSH (n= 54) ve HP-uFSH n= 48) kli nis ye nin se çi mi ve has ta nın ter ci hi ne gö re ve ril di. B Bu ul l g gu u l la ar r: : r FSH te da vi si fol li kü ler ge li şi mi in dük le mek için da ha az ilaç ge rek tir di ve hu man ko ri yo nik go na dot ro pin (hCG) injek si yon gü nün de da ha yük sek plaz ma es tra di ol dü zey le riy le so nuç lan dı. Ge be lik ora nı r FSH gru bun da HP-uFSH gru bu na gö re da ha yük sek ol ma sı na rağ men (%40.7'ye kar şı %33.3), arada ki fark is ta tis tik sel ola rak an lam lı de ğil di. To plam FSH do zu r FSH gru bun da HP-uFSH'tan an lam lı de re ce de da ha dü şük tü (1396.3 ± 131....

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“…Ovaries of patients with PCOS are over-sensitive to the effects of FSH and therefore a low dose step-up protocol is recommented. 5,8 In our study, we aim to compare the treatment success and complication rates of clomiphene citrate (CC) and gonadotopins (r-FSH) using low dose step-up protocol, which are the two most frequently used ovulation induction agents in patients with polycystic ovary syndrome (PCOS).…”

Section: Comparison Of Clomiphene Citrate and Low Dose Recombinant Fsmentioning

confidence: 99%

Comparison of Clomiphene Citrate and Low Dose Recombinant FSH for Induction of Ovulation in Infertile Women with Polycystic Ovary Syndrome

Akçelik¹,

Çöğendez²,

Şilfeler³

et al. 2015

Turkiye Klinikleri J Gynecol Obst

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A AB BS S TTR RA AC CT T O Ob bj je ec ct ti iv ve e: : In our study, we aim to compare the treatment success and complication rates of clomiphene citrate (CC) and gonadotopins (r-FSH) using low dose step-up protocol, which are both frequently used as induction of ovulation protocols in patients with polycystic ovary syndrome (PCOS). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : 138 patients with PCOS who presented at our infertility outpatient clinic and underwent ovulation induction were included in the study. Diagnosis of PCOS was reached using Rotterdam Criteria after exclusion of other etiological factors. Induction of ovulation was performed on 86 patients with CC and 52 patients with recombinant FSH (r-FSH) using low dose step-up protocol. Clomiphene citrate (n=86) was administered between the 5 th and 9 th days of the menstrual cycle with an initial dose of 50 mg/day. Ovulation induction with r-FSH (n=52) was done using low dose step-up protocol with an initial dose of 75 IU/day. R Re es su ul lt ts s: : Number of follicles was significantly higher in patients in the r-FSH group (p=0.01). The incidence of ovarian hyperstimulation syndrome (OHSS) did not differ significantly among the groups (p=0.487). Also there was no significant difference in pregnancy ratios between two groups (p=0.064). Pregnancy ratios in the r-FSH and CC groups were found to be 12.5% and 5.9%, respectively. Of the pregnant subjects in the CC groups (n=8), one had a miscarriage at 10 th gestational week; one live birth and 1 stillbirth was observed while pregnancies of the remaining 5 (62.5%) were maintained. Within the r-FSH group, where 16 subjects got pregnant, 6 live births (37.5%) and 1 stillbirth (6.3%) observed, and 2 subjects (12.5%) had first trimester abortus. 7 subjects of this group (43.8%) had their pregnancies maintained, while two of these were multiple pregnancies (one couplet and one triplet). C Co on nc cl lu us si io on n: : Clomiphene citrate should be the first line treatment in the ovulation induction of patients with PCOS due to its low costs, easier patient monitorization (oral use), and lower risk of multiple pregnancies and OHSS. On the other hand, we think that administration of r-FSH in PCOS patients using low dose step-up protocol is a safe approach. Therefore, it should be the treatment of choice in patients who do not respond to CC of maximum dosage or for 6 or more cycles. K Ke ey y W Wo or rd ds s: : Clomiphene; gonadotropins; infertility; polycystic ovary syndrome Ö ÖZ ZE ET T A Am ma aç ç: : Çalışmamızın amacı, polikistik over sendromlu (PCOS) hastalarda ovulasyon indüksiyon protokolü olarak sıklıkla kullanılan klomifen sitrat (CC) ve düşük doz step up protokolü ile uygulanan gonadotropinlerin (r-FSH) tedavi başarısı ile komplikasyon oranları açısından karşılaştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : İnfertilite polikliniğimize başvuran ve ovulasyon indüksiyonu yapılan 138 PCOS olgusu çalışmaya dâhil edildi. PCOS tanısı diğer etyolojik faktörleri dışladıktan so...

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A comparative randomized multicentric study comparing the step-up versus step-down protocol in polycystic ovary syndrome

Cited by 138 publications

References 21 publications

Efficacy of extended clomifene citrate regimen in comparison with gonadotropins in clomifene citrate-resistant women with polycystic ovary syndrome

Efficacy of extended clomifene citrate regimen in comparison with gonadotropins in clomifene citrate-resistant women with polycystic ovary syndrome

Comparison of the Recombinant Versus Highly-Purified, Urinary Follicle-Stimulating Hormone (r-FSH vs. HP-uFSH) in the Polycystic Ovary Syndrom Patients who had Antagonist Cycle with In Vitro Fertilization- mbryo Transfer

Comparison of Clomiphene Citrate and Low Dose Recombinant FSH for Induction of Ovulation in Infertile Women with Polycystic Ovary Syndrome

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