Proper selection of patients for intermediate-dose pure follicle stimulating hormone.
Forty-four polycystic ovary syndrome (PCO) patients were treated for a total of 61 cycles with intermediate-dose pure follicle stimulating hormone (FSH). Patient selection was based on hyperandrogenism, oligoovulation and physical signs. Patients with multiple-factor infertility were excluded from the study. Seventeen conception cycles occurred in 17 patients (pregnancy cycles). The spontaneous abortion rate was 29.4%. Forty cycles did not result in conception (Nonpregnancy cycles, 23 patients). Treatment was discontinued in four patients who had suboptimal response. Sixteen pregnancies (94%) occurred within the first two treatment cycles. Pregnancy and nonpregnancy cycles were compared for characteristics associated with a successful outcome. The data suggest that (1) an intermediate-dose pure FSH protocol is most likely to be successful among more "classic" PCO patients, those with obesity, high body surface area, elevated luteinizing hormone/FSH ratio and higher testosterone; (2) if pregnancy is to occur, it is most likely to within two treatment cycles; and (3) ovarian hyperstimulation is more likely to occur in nonconception cycles.
Kim
J H
JH
Faulkner Centre for Reproductive Medicine, Faulkner Hospital, Boston, MA 02130.
Richards
C J
CJ
Seibel
M M
MM
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D000858:Anovulation / Q000209:etiology*; D001830:Body Surface Area; D002985:Clinical Protocols; D004341:Drug Evaluation; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology*; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle; D009765:Obesity / Q000209:etiology*; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood; D017211:Treatment Failure
D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone