Gonadotrophin therapy for ovulation induction in subfertility associated with polycystic ovary syndrome

Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility

“…persistent hypersecretion of LH, or an anti-oestrogenic endometrial effects). To prevent overstimulation and multiple pregnancy, the traditional standard step-up regimens (Lunenfeld and Insler, 1974) were replaced by either low-dose step-up regimens (Hamilton-Fairley et al , 1991; White et al , 1996) or step-down regimens (van Santbrink et al , 1995) with gonadotrophins used alone and different gonadotrophin preparations appearing to work equally well (Nugent et al , 2000). It can be difficult to predict stimulation responses in PCOS and to achieve a single dominant follicle to reduce multiple pregnancy and OHSS, and careful monitoring of follicular development by ultrasound is required with triggers only used with two or less follicles over 14 mm.…”

Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility

“…persistent hypersecretion of LH, or an anti-oestrogenic endometrial effects). To prevent overstimulation and multiple pregnancy, the traditional standard step-up regimens (Lunenfeld and Insler, 1974) were replaced by either low-dose step-up regimens (Hamilton-Fairley et al , 1991; White et al , 1996) or step-down regimens (van Santbrink et al , 1995) with gonadotrophins used alone and different gonadotrophin preparations appearing to work equally well (Nugent et al , 2000). It can be difficult to predict stimulation responses in PCOS and to achieve a single dominant follicle to reduce multiple pregnancy and OHSS, and careful monitoring of follicular development by ultrasound is required with triggers only used with two or less follicles over 14 mm.…”

Prevention of Ovarian Hyperstimulation Syndrome: A Review

“…In their Cochrane Review, Nugent et al highlighted the sequelae of this through the higher overstimulation rate (OR 3.15; 95% CI 1.48–6.70). This coupled with the increased cost and additional inconvenience without an increase in pregnancy rates prompted them to make a recommendation against its use [ 33 ].…”

Use of exogenous gonadotropins in anovulatory women: a technical bulletin

“…Another study, not included in the 2003 systematic review, reported 18 pregnancies in 28 women with HA across 72 cycles of treatment (25% per cycle), but only 16 pregnancies in 61 hyperandrogenic women with PCOS across 205 cycles of treatment (8% per cycle) (35). The type of gonadotropin did not appear to have significant influence on pregnancy rate in four trials involving 396 patients treated with FSH (12%) or hMG (10%) (OR 0.82, 95% CI 0.44-1.53) (36).…”

Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility

“…persistent hypersecretion of LH, or an anti-oestrogenic endometrial effects). To prevent overstimulation and multiple pregnancy, the traditional standard step-up regimens (Lunenfeld and Insler, 1974) were replaced by either low-dose step-up regimens (Hamilton-Fairley et al , 1991; White et al , 1996) or step-down regimens (van Santbrink et al , 1995) with gonadotrophins used alone and different gonadotrophin preparations appearing to work equally well (Nugent et al , 2000). It can be difficult to predict stimulation responses in PCOS and to achieve a single dominant follicle to reduce multiple pregnancy and OHSS, and careful monitoring of follicular development by ultrasound is required with triggers only used with two or less follicles over 14 mm.…”

Prevention of Ovarian Hyperstimulation Syndrome: A Review

“…In their Cochrane Review, Nugent et al highlighted the sequelae of this through the higher overstimulation rate (OR 3.15; 95% CI 1.48–6.70). This coupled with the increased cost and additional inconvenience without an increase in pregnancy rates prompted them to make a recommendation against its use [ 33 ].…”

Use of exogenous gonadotropins in anovulatory women: a technical bulletin

“…Another study, not included in the 2003 systematic review, reported 18 pregnancies in 28 women with HA across 72 cycles of treatment (25% per cycle), but only 16 pregnancies in 61 hyperandrogenic women with PCOS across 205 cycles of treatment (8% per cycle) (35). The type of gonadotropin did not appear to have significant influence on pregnancy rate in four trials involving 396 patients treated with FSH (12%) or hMG (10%) (OR 0.82, 95% CI 0.44-1.53) (36).…”

Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility

“…persistent hypersecretion of LH, or an anti-oestrogenic endometrial effects). To prevent overstimulation and multiple pregnancy, the traditional standard step-up regimens (Lunenfeld and Insler, 1974) were replaced by either low-dose step-up regimens (Hamilton-Fairley et al , 1991; White et al , 1996) or step-down regimens (van Santbrink et al , 1995) with gonadotrophins used alone and different gonadotrophin preparations appearing to work equally well (Nugent et al , 2000). It can be difficult to predict stimulation responses in PCOS and to achieve a single dominant follicle to reduce multiple pregnancy and OHSS, and careful monitoring of follicular development by ultrasound is required with triggers only used with two or less follicles over 14 mm.…”

Prevention of Ovarian Hyperstimulation Syndrome: A Review

“…In their Cochrane Review, Nugent et al highlighted the sequelae of this through the higher overstimulation rate (OR 3.15; 95% CI 1.48–6.70). This coupled with the increased cost and additional inconvenience without an increase in pregnancy rates prompted them to make a recommendation against its use [ 33 ].…”

Use of exogenous gonadotropins in anovulatory women: a technical bulletin

“…Another study, not included in the 2003 systematic review, reported 18 pregnancies in 28 women with HA across 72 cycles of treatment (25% per cycle), but only 16 pregnancies in 61 hyperandrogenic women with PCOS across 205 cycles of treatment (8% per cycle) (35). The type of gonadotropin did not appear to have significant influence on pregnancy rate in four trials involving 396 patients treated with FSH (12%) or hMG (10%) (OR 0.82, 95% CI 0.44-1.53) (36).…”