Low-dose FSH stimulation in polycystic ovary syndrome: Comparison of 3 FSH-preparations

Abstract

In patients with PCOS low dose administration of follicle stimulating hormone is accepted as a safe treatment modality with low risk for an ovarian hyperstimulation syndrome or a multiple pregnancy. In this study we have retrospectively compared the efficacy of 3 different FSH preparations in low dose protocols-urinary FSH (FSH), highly purified urinary FSH (FSHHP) and recombinant FSH (rec. FSH). A total of 68 PCOS-patients, 36 lean and 32 moderately obese patients, were treated in 116 stimulation cycles. The mean age did not differ between the groups. A mean number of 1.7 cycles per patient was performed. PCOS was diagnosed in all patients by hormonal and sonographic means. Treatment was performed with daily injections of one ampoule FSH from day 3 onwards. Ovulation was induced with 10,000 IU HCG, when the leading follicle exceeded 16 mm in diameter and no more than 3 follicles were seen. The rate of monofollicular cycles was lowest in obese patients after FSHHP stimulation (30%) and after rec. FSH (66.6% in lean and 58.3% in obese patients, respectively). The number of FSH ampoules did not differ significantly between the groups. No severe hyperstimulation syndrome was registered. 21 pregnancies were achieved without significant differences between the different FSH preparations. Besides two abortions and one ectopic implantation, 12 pregnancies were ongoing singleton pregnancies, 3 twin pregnancies and 3 sets of triplets were noted. In conclusion, low-dose stimulation with FSH offers a safe and successful treatment option in patients with PCOS with an acceptable risk for multiple gestations.

Regulation of androgen receptor signaling by ubiquitination during folliculogenesis and its possible dysregulation in polycystic ovarian syndrome

“…It is used commonly in infertility therapy including controlled ovarian stimulation in in vitro fertilization and for PCOS patients 22 , 45 . It offers a safe and successful treatment option in patients with PCOS with an acceptable risk for multiple gestations 51 . Our previous and present studies show that gonadotropin enhances sKitlg mRNA and protein contents on the antral follicles and attenuates DHT-induced antral follicles arrest in vivo 33 , 34 .…”

Management strategies for ovulation induction in women with polycystic ovary syndrome and known clomifene citrate resistance

“…More recently, a 'very-lowdose' step-up protocol consisting of FSH at the starting dose of 37.5 UI daily has been proposed to further reduce the risks related to gonadotropins administration in PCOS [22].…”