Gonadotropin stimulation protocols in the Norfolk IVF program--1988.
A standard FSH/hMG stimulation protocol applied to all patients does not yield optimum results. In the Norfolk program it has been found that the determination of FSH/LH ratio on day 3 of the menstrual cycle provides a predictive signal of the likelihood of a good or bad response to a standard protocol. If the FSH is high in relation to LH, the patient will likely be a low responder and/or approaching the menopause. A regime of high-dose pure FSH seems to improve the number of eggs in this group and therefore the pregnancy rate. On the other hand, if the FSH/LH ratio is very low, that is, the patient has a high LH, the patient is generally a high responder and produces many eggs, but in some instances the quality of eggs is suspect, and the pregnancy rate is low in a particular subset of high responders. The use of GnRHa and/or minimal stimulation with FSH or hMG seems to improve the pregnancy rate.
Jones
G S
GS
Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk 23507.
Muasher
S J
SJ
Liu
H C
HC
D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000494:pharmacology*; D006801:Humans; D007986:Luteinizing Hormone / Q000494:pharmacology*; D008596:Menotropins / Q000494:pharmacology*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000378:metabolism; D011247:Pregnancy
D008596:Menotropins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone