The clinical efficacy of low-dose step-up follicle stimulating hormone administration for treatment of unexplained infertility.
The present study was designed to compare the clinical efficacy of low-dose step-up follicle stimulating hormone (FSH) administration with conventional FSH protocol (FSH was injected daily starting with a dose of 150 IU), both combined with intrauterine insemination (IUI), for the treatment of unexplained infertility. A total of 97 unexplained infertility couples was randomly assigned to one or other of the two treatment groups, either conventional FSH with IUI (48 patients) or low-dose step-up FSH with IUI (49 patients), and only the first treatment cycle was evaluated in each protocol. The difference in pregnancy rates per cycle was not statistically significant between the low-dose FSH group and the conventional group [seven of 49 (14.3%) and seven of 48 (14.6%) respectively]. A significant reduction in the incidence of ovarian hyperstimulation syndrome (OHSS) was observed in the low-dose group (8.3% versus 27.1%, P < 0.05). The incidence of moderate OHSS requiring hospitalization was reduced significantly in the low-dose group (low-dose 0% versus conventional 16.7%, P < 0.01). However, the low-dose protocol did not completely prevent multiple pregnancies. Our results suggest that the low-dose step-up FSH treatment appeared to be useful for the treatment of unexplained infertility because of the high pregnancy rates and the significant decrease in the incidence of OHSS.
Sengoku
K
K
Department of Obstetrics and Gynecology, Asahikawa Medical College, Japan.
Tamate
K
K
Takaoka
Y
Y
Horikawa
M
M
Goishi
K
K
Komori
H
H
Okada
R
R
Tsuchiya
K
K
Ishikawa
M
M
D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage* / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007246:Infertility / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D014427:Twins
D005640:Follicle Stimulating Hormone