The clinical efficacy of low-dose step-up follicle stimulating hormone administration for treatment of unexplained infertility.

Abstract	The present study was designed to compare the clinical efficacy of low-dose step-up follicle stimulating hormone (FSH) administration with conventional FSH protocol (FSH was injected daily starting with a dose of 150 IU), both combined with intrauterine insemination (IUI), for the treatment of unexplained infertility. A total of 97 unexplained infertility couples was randomly assigned to one or other of the two treatment groups, either conventional FSH with IUI (48 patients) or low-dose step-up FSH with IUI (49 patients), and only the first treatment cycle was evaluated in each protocol. The difference in pregnancy rates per cycle was not statistically significant between the low-dose FSH group and the conventional group [seven of 49 (14.3%) and seven of 48 (14.6%) respectively]. A significant reduction in the incidence of ovarian hyperstimulation syndrome (OHSS) was observed in the low-dose group (8.3% versus 27.1%, P < 0.05). The incidence of moderate OHSS requiring hospitalization was reduced significantly in the low-dose group (low-dose 0% versus conventional 16.7%, P < 0.01). However, the low-dose protocol did not completely prevent multiple pregnancies. Our results suggest that the low-dose step-up FSH treatment appeared to be useful for the treatment of unexplained infertility because of the high pregnancy rates and the significant decrease in the incidence of OHSS.
Authors	K Sengoku, K Tamate, Y Takaoka, M Horikawa, K Goishi, H Komori, R Okada, K Tsuchiya, M Ishikawa
Journal	Human reproduction (Oxford, England) (Hum Reprod) Vol. 14 Issue 2 Pg. 349-53 (Feb 1999) ISSN: 0268-1161 [Print] England
PMID	10099977 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References	Follicle Stimulating Hormone
Topics	Adult Dose-Response Relationship, Drug Female Follicle Stimulating Hormone (administration & dosage, therapeutic use) Hospitalization Humans Incidence Infertility (drug therapy, etiology) Male Ovarian Hyperstimulation Syndrome (epidemiology, physiopathology, prevention & control) Pregnancy Pregnancy Rate Pregnancy, Multiple Twins

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