Treatment-associated serum FSH levels in very poor responders to ovarian stimulation.
OBJECTIVE
To compare treatment-associated follicle-stimulating hormone (FSH) response in patients undergoing controlled ovarian hyperstimulation with either microdose flare (MDF) leuprolide acetate or clomiphene citrate and human menopausal gonadotropin (CC/hMG).


METHODS
Thirteen patients who were deemed poor responders underwent stimulation with one of two poor responder stimulation protocols (MDF group: n = 8; CC/hMG group: n = 5). Serum FSH, estrone (E1), estrone sulfate (E1S), and estradiol (E2) levels were measured at baseline, day 5 of medication, and on day of hCG administration. Ovarian and uterine responses were evaluated by ultrasound.


RESULTS
Treatment-associated FSH levels were consistently higher in the group that took CC/hMG. However, serum E1, E1S, and E2 values were similar in both groups as were the number of oocytes retrieved and the endometrial echo complex. There were no differences between the two groups with regards to the quality of the oocytes obtained, fertilization rate, or the quality of the embryos.


CONCLUSIONS
Clomiphene citrate, when administered in conjunction with exogenous hMG, is a more potent stimulator of FSH production than MDF leuprolide acetate among poor responders to ovarian stimulation. However, the number of oocytes is not increased.
Saadat
Peyman
P
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA. peymansaadat@hotmail.com
Slater
Cristin C
CC
Jain
John K
JK
Tourgeman
David E
DE
Stanczyk
Frank Z
FZ
Paulson
Richard J
RJ
D000328:Adult; D015992:Body Mass Index; D002452:Cell Count; D002996:Clomiphene / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood*; D004970:Estrone / Q000031:analogs & derivatives* / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D009865:Oocytes / Q000166:cytology / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods*; D012189:Retrospective Studies
D005300:Fertility Agents, Female; D002996:Clomiphene; D004970:Estrone; D004958:Estradiol; D005640:Follicle Stimulating Hormone; D016729:Leuprolide; C017296:estrone sulfate