Gonadotrophin induction of ovulation using a step-down dose regimen: single-centre clinical experience in 82 patients.

Abstract

A total of 82 normogonadotrophic clomiphene-resistant anovulatory patients were treated with exogenous gonadotrophins according to a step-down dose regimen during 234 cycles. In 43 (18%) cycles co-treatment with gonadotrophin-releasing hormone analogues was applied. The initial dose was between 1.5 and 2.5 ampoules (75 IU follicle-stimulating hormone each) per day (dependent on body weight), and decreasing steps of 0.5 ampoules/day were based on sonographic findings. The overall ovulation rate was 91% (213 cycles). The median treatment period was 11 days and a total of 14 ampoules of gonadotrophin were needed. In 131 (62%) of the ovulatory cycles not more than one, and in 208 (98%) cycles not more than two, follicles > or = 16 mm were present on the day human chorionic gonadotrophin was given. A total of 37 pregnancies occurred of which two were twins and one was a triplet (multiple pregnancy rate 8%). The pregnancy rate per cycle was 17% and the cumulative pregnancy rate after 7 months was 47%. The abortion rate was 19%. There were four (1.7%) cases of mild ovarian hyperstimulation, of which none became pregnant. In conclusion, this study shows that the applied step-down regimen for gonadotrophin induction of ovulation can be a safe and effective treatment alternative for patients with clomiphene-resistant anovulation. The duration of ovarian stimulation and the amount of exogenous gonadotrophin required is limited. Pregnancy rates are comparable with those reported for step-up regimens, and a low incidence of complications (i.e. multiple gestation and ovarian hyperstimulation) was noted.(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: E J van Santbrink, P F Donderwinkel, T J van Dessel, B C Fauser
• Journal: Human reproduction (Oxford, England) (Hum Reprod) Vol. 10 Issue 5 Pg. 1048-53 (May 1995) ISSN: 0268-1161 [Print] England
• PMID: 7657739 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Chorionic Gonadotropin
• Gonadotropins
• Clomiphene
• Menotropins
• Follicle Stimulating Hormone
• Buserelin

Topics

• Adult
• Buserelin (administration & dosage)
• Chorionic Gonadotropin (administration & dosage)
• Clomiphene (pharmacology)
• Drug Resistance
• Female
• Follicle Stimulating Hormone (administration & dosage, blood)
• Gonadotropins (administration & dosage)
• Humans
• Infertility, Female (drug therapy)
• Menotropins (administration & dosage)
• Ovulation Induction (methods)
• Pregnancy
• Time Factors