title: A randomised controlled trial of 300 versus 225 IU recombinant FSH for ovarian stimulation in predicted normal responders by antral follicle count.
abstract: 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.
authors.affiliation: 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
authors.forename: K
authors.initials: K
authors.lastname: Jayaprakasan
authors.forename: J
authors.initials: J
authors.lastname: Hopkisson
authors.forename: B
authors.initials: B
authors.lastname: Campbell
authors.forename: I
authors.initials: I
authors.lastname: Johnson
authors.forename: J
authors.initials: J
authors.lastname: Thornton
authors.forename: N
authors.initials: N
authors.lastname: Raine-Fenning
mesh_terms: 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
chemical_list: D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D017274:Nafarelin; D002064:Buserelin