Ovulation induction with low doses of "pure" follicle stimulating hormone using a fixed protocol in patients with polycystic ovarian disease.
OBJECTIVE
Use of a low, fixed dose of purified FSH to induce ovulation in polycystic ovarian syndrome.


METHODS
Fixed protocol, using 75 IU/day of "pure" FSH starting on day 1-5 of menses.


METHODS
University outpatient clinic.


METHODS
Seventeen patients, aged 18-38, with clomiphene-resistant polycystic ovarian syndrome, for 23 cycles. All received 50 mg medroxyprogesterone to induce menstrual flow. "Pure" FSH given i.m. for eight to ten days. If follicle reached > or = 18 mm, hCG (5,000 IU) was given, in one-half of cases, in a single dose to induce rupture.


METHODS
Hormonal measurements (plasma LH, FSH, estradiol, testosterone, progesterone); daily, LH/FSH ratio; daily abdominal sonogram.


RESULTS
I: No follicular growth (3 cycles; 13%); II: Inadequate follicular growth (< or = 14 mm--6 cycles; 26%); IIIa: Follicle > or = 18 mm, hCG given; 100% ovulatory; IIIb: Follicle > or = 18 mm, no hCG given; 2/7 ovulatory. Hyperstimulation: one (moderate) in IIIa; one (mild) in IIIb.


CONCLUSIONS
Fixed protocol of low-dose, "pure" FSH produces good results, especially combined with hCG, which is effective up to 48 hours after last injection of FSH.
Bregieiro
L O
LO
Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paolo, Brazil.
de Moura
M D
MD
Ferriani
R A
RA
Bailão
L A
LA
de Sá
M F
MF
D000293:Adolescent; D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007246:Infertility / Q000188:drug therapy / Q000209:etiology; D007273:Injections, Intramuscular; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008525:Medroxyprogesterone / Q000627:therapeutic use; D006080:Ovarian Follicle / Q000187:drug effects / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D011374:Progesterone / Q000097:blood; D013739:Testosterone / Q000097:blood; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D008525:Medroxyprogesterone