Purified follicle-stimulating hormone in polycystic ovary syndrome: slow administration is safer and more effective.
Twenty-seven infertile patients presenting with clomiphene citrate- (CC) resistant polycystic ovary syndrome (PCOS) were treated with purified urinary follicle-stimulating hormone (pFSH). We compared the conventional stepwise protocol with a slow protocol starting with 75 IU/d, not increased until 14 days, supplemented by human chorionic gonadotropins (hCG). The slow protocol was characterized by a slightly longer duration of stimulation but a more physiological ovarian response (mono- or biovulatory cycles in 70% versus 19% with the conventional protocol, less follicles, and a lower plasma estradiol [E2] resulting in significantly less discontinuation of treatment for risk of hyperstimulation or multiple birth). The pregnancy rate per cycle was higher with the slow protocol (23% versus 15%). The slow protocol could thus be the treatment of choice for CC-resistant PCOS, as it appeared safer and more effective.
Buvat
J
J
Association EPARP, Lille, France.
Buvat-Herbaut
M
M
Marcolin
G
G
Dehaene
J L
JL
Verbecq
P
P
Renouard
O
O
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage* / Q000627:therapeutic use; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D008593:Menopause / Q000378:metabolism; D006080:Ovarian Follicle / Q000473:pathology / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors
D006063:Chorionic Gonadotropin; D006062:Gonadotropins; D005640:Follicle Stimulating Hormone