The safety and effectiveness of stepwise and low-dose administration of follicle stimulating hormone in WHO group II anovulatory infertile women: evidence from a large multicenter study in Spain.

Our goal was to investigate the safety, effectiveness, and feasibility for the practicing physician of stepwise and low-dose administration of FSH in WHO group II anovulatory infertile women.
Infertile female patients (n = 234) suffering from WHO group II anovulation, and who failed to became pregnant with clomiphene citrate, were included in a multicenter, prospective, clinical study of treatment with a protocol of chronic low-dose and small incremental rises with urinary purified or highly purified FSH. Follicular development was monitored with ultrasonographic scans.
The 234 patients received a total of 534 cycles of treatment, for a mean number of 2.3 treated cycles per patient. hCG was withheld in 65 (12.2%) cyles because of no response and in 28 (5.2%) cycles because of hyperresponse. Of the remaining 441 cycles, 419 (95%) were ovulatory, and in 198 (47.3%) of these cycles a single dominant follicle developed. There were 93 pregnancies (39.7% per patient), for a cycle fecundity rate of 17.4%. Cumulative conception rate after two treated cycles was 33.5%. There were 14 (15%) pairs of twins and 10 (10.8%) spontaneous miscarriages. The prevalence of complications was low with no cases of severe OHSS. Basal LH/FSH ratio was significantly higher in the pregnant group of patients than in nonpregnant women.
Stepwise and chronic low-dose administration of FSH is a safe and effective method for treatment of WHO group II anovulatory infertility, mainly in those patients having high LH/FSH ratios.
AuthorsJ Balasch, R Tur, P Alvarez, J M Bajo, E Bosch, I Bruna, P Caballero, J Calaf, I Cano, E Carrillo, J A Duque, G Folguera, A de la Fuente, C Jiménez, G Laguens, E López, A Lozano, A Matarranz, C Moreno, J Nava, M Sanchis, E Temprano, G Ventura, J A Peinado
JournalJournal of assisted reproduction and genetics (J Assist Reprod Genet) Vol. 13 Issue 7 Pg. 551-6 (Aug 1996) ISSN: 1058-0468 [Print] UNITED STATES
PMID8844311 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)
Chemical References
  • Follicle Stimulating Hormone
  • Adult
  • Anovulation (drug therapy, ultrasonography)
  • Female
  • Follicle Stimulating Hormone (administration & dosage)
  • Humans
  • Pregnancy
  • Prospective Studies
  • Safety
  • Spain

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