A randomised controlled trial of 300 versus 225 IU recombinant FSH for ovarian stimulation in predicted normal responders by antral follicle count.
OBJECTIVE
To test the hypothesis that among women predicted to have a normal ovarian response, ovarian stimulation using 300 IU follicle-stimulating hormone (FSH) results in the retrieval of more mature oocytes than 225 IU during in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) treatment.


METHODS
Prospective randomised controlled study.


METHODS
University-based assisted conception unit.


METHODS
A cohort of 131 women predicted to have a normal ovarian response to gonadotrophin stimulation, based on antral follicle count.


METHODS
Subjects undergoing their first cycle of IVF/ICSI were randomised to receive a fixed daily dose of 300 (experimental arm) or 225 IU (control arm) of recombinant FSH (Gonal-F).


METHODS
Number of mature oocytes retrieved and live birth rates.


RESULTS
The number (mean +/- standard deviation) of mature oocytes retrieved (8.2 +/- 5.0 versus 9.0 +/- 4.8, for 300 and 225 IU, respectively; P = 0.34) was similar in each group. There were no differences between the 300- and 225 IU arms in live birth rates (31 versus 41%, respectively; P = 0.25), cycle cancellations resulting from insufficient ovarian response (0 versus 6.1%, respectively; P = 0.12), and prevalence of moderate (3.1 versus 3.0, respectively; P = 1.0) and severe (0 versus 1.5%, respectively; P = 1.0) ovarian hyperstimulation syndrome.


CONCLUSIONS
The use of a higher daily dose of 300 IU of recombinant FSH for ovarian stimulation does not improve the number of mature oocytes retrieved, or live birth rates, among women with a predicted normal response during conventional IVF/ICSI.
Jayaprakasan
K
K
Nottingham University Research and Treatment Unit in Reproduction, Division of Human Development, School of Clinical Sciences, University of Nottingham, Nottingham, UK. k.jayaprakasan@nottingham.ac.uk
Hopkisson
J
J
Campbell
B
B
Johnson
I
I
Thornton
J
J
Raine-Fenning
N
N
D000328:Adult; D002064:Buserelin / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro; D043373:Follicle Stimulating Hormone, Human / Q000008:administration & dosage*; D006801:Humans; D017274:Nafarelin / Q000627:therapeutic use; D054315:Oocyte Retrieval / Q000379:methods; D009865:Oocytes / Q000187:drug effects; D006080:Ovarian Follicle / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D017274:Nafarelin; D002064:Buserelin