title: Comparison of highly purified urinary versus recombinant FSH: Effect on ART outcomes in polycystic ovary syndrome.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is a common cause of ovulatory disorders and infertility with high LH to FSH ratio. In order to prevent further increase of LH and follicle atresia, different regimens for ovulation induction have been recommended using FSH alone.
  
  
  OBJECTIVE
  This study was performed in PCOS patients to compare ART outcomes in cycles induced by FSH alone, using either recombinant or urinary products.
  
  
  METHODS
  In a randomized trial, from 623 patients who underwent down regulation with GnRH analogue in a long protocol, 160 PCOS patients were randomly divided into two groups of 80. Group A received 150 IU/d recombinant FSH (Gonal-F) and group B 150 IU/d urinary FSH (Fostimon).
  
  
  RESULTS
  33 cases (41.2%) in group A and 36 (45%) in group B achieved clinical pregnancy, which was not significantly different (p=0.67). Total number of oocytes retrieved (13.03±5.56 vs. 14.17±4.89, p=0.17), quality and number of embryos (7.42±3.35 vs. 7.63±3.28, p=0.68) and OHSS rate were similar in group A compared to group B. Endometrial thickness which was 9.66±1.67 mm in group A and 10.36±1.35 mm in group B, showed a significant difference (p=0.004).
  
  
  CONCLUSIONS
  It seems that in PCOS patients, both pure FSH products used for controlled ovarian hyperstimulation have similar effects on ART outcome and can be used according to availability and patient acceptance without significant difference.
authors.affiliation: Department of Obstetrics- Gynecology and Infertility, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Farnaz
authors.initials: F
authors.lastname: Sohrabvand
authors.affiliation: Department of Obstetrics- Gynecology and Infertility, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Sheikhhassani
authors.affiliation: Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Bagheri
authors.affiliation: Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Fedyeh
authors.initials: F
authors.lastname: Haghollahi
authors.affiliation: Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Shabihkhani
authors.affiliation: Maternal- Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mamak
authors.initials: M
authors.lastname: Shariat
authors.affiliation: Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Manijeh
authors.initials: M
authors.lastname: Nasr Esfahani
keywords: ART outcome; Clinical pregnancy rate; Highly purified urinary FSH; PCOS; Recombinant FSH