Urinary follicle-stimulating hormone (FSH) versus recombinant FSH in clomiphene citrate-resistant, normogonadotropic,chronic anovulation: a prospective randomized study.
OBJECTIVE
To compare the efficacy and safety of urinary FSH and recombinant FSH for ovulation induction in patients with clomiphene citrate-resistant, normogonadotropic, chronic anovulation.


METHODS
Prospective, randomized trial.


METHODS
University-based infertility clinic.


METHODS
Fifty-one women.


METHODS
Subjects were randomized to receive either urinary FSH (35 patients, 64 cycles) or recombinant FSH (16 patients, 32 cycles). A maximum of three cycles using the low-dose step-up protocol with the same gonadotropin were undertaken.


METHODS
Cumulative ovulation and pregnancy rates after three cycles, total gonadotropin dose, duration of stimulation, and single follicle development rate.


RESULTS
Cumulative ovulation rates were 89.3% and 93.1% for the urinary FSH and recombinant FSH groups, respectively. The threshold and total doses of FSH and the duration of stimulation were similar between the two groups. Significantly more single follicle development was noted in the recombinant FSH group. The respective clinical pregnancy rates per noncanceled cycles in the urinary FSH and recombinant FSH groups were 23.2% and 27.6%. There were three sets of twins in the urinary FSH group. No case of ovarian hyperstimulation syndrome was encountered.


CONCLUSIONS
Urinary FSH and recombinant FSH are both efficient and safe for inducing ovulation with the low-dose step-up protocol.
Yarali
H
H
Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Bukulmez
O
O
Gurgan
T
T
D000328:Adult; D000858:Anovulation; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D002996:Clomiphene / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use* / Q000652:urine; D006801:Humans; D007247:Infertility, Female; D010060:Ovulation / Q000187:drug effects / Q000502:physiology*; D011247:Pregnancy; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D017211:Treatment Failure
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D011994:Recombinant Proteins; D002996:Clomiphene; D004958:Estradiol; D005640:Follicle Stimulating Hormone