Recombinant follicle stimulating hormone stimulation in poor responders with normal basal concentrations of follicle stimulating hormone and oestradiol:: improved reproductive outcome

被引:69
作者
Raga, F
Bonilla-Musoles, F
Casañ, EM
Bonilla, F
机构
[1] Univ Valencia, Sch Med, Ctr Obstet & Gynecol, Valencia 46004, Spain
[2] Univ Valencia, Sch Med, Dept Obstet & Gynecol, Valencia 46004, Spain
[3] Hosp Clin Univ, Valencia, Spain
关键词
poor responder; recombinant FSH; reproductive performance;
D O I
10.1093/humrep/14.6.1431
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
A total of 30 young infertile patients who exhibited a poor response in two previous consecutive cycles, despite having normal basal follicle stimulating hormone (FSH) and oestradiol concentrations, were invited to participate in a prospective randomized study comparing the clinical efficacy of recombinant (rFSH) and urinary (uFSH) follicle stimulating hormone, An evaluation of the total dose used (3800 IU versus 4600 IU, P < 0.05) and duration of treatment (10.2 days versus 13.2 days, P < 0.05) showed a significantly shorter treatment period as well as a significantly lower total dose of FSH required to induce ovulation successfully in the group of patients treated with rFSH, Significantly more oocytes (7.2 versus 5.6, P < 0.05) as well as mature oocytes (5.9 versus 3.2, P < 0.01) were retrieved after rFSH treatment, In addition, significantly more good quality embryos were obtained (3.4 versus 1.8, P < 0.05) in the group of patients treated with rFSH and, as a result, higher pregnancy (33 versus 7%, P < 0.01) and implantation (16 versus 3%, P< 0.01) rates were achieved in these patients. It is concluded that rFSH is more effective than uFSH in inducing multifollicular development and achieving pregnancy in young low responders.
引用
收藏
页码:1431 / 1434
页数:4
相关论文
共 33 条
[1]   Premature ovarian failure: an update [J].
Anasti, JN .
FERTILITY AND STERILITY, 1998, 70 (01) :1-15
[2]   OCCULT OVARIAN FAILURE - A SYNDROME OF INFERTILITY, REGULAR MENSES, AND ELEVATED FOLLICLE-STIMULATING-HORMONE CONCENTRATIONS [J].
CAMERON, IT ;
OSHEA, FC ;
ROLLAND, JM ;
HUGHES, EG ;
DEKRETSER, DM ;
HEALY, DL .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1988, 67 (06) :1190-1194
[3]  
*CPMP WORK PART EF, 1990, PHARMACOL TOXICOL, V67, P361
[4]   Structure-function relationship of recombinant follicle stimulating hormone (Puregon®) [J].
de Leeuw, Renato ;
Mulders, John ;
Voortman, Gerrit ;
Rombout, Ferdy ;
Damm, Jan ;
Kloosterboer, Lenus .
MOLECULAR HUMAN REPRODUCTION, 1996, 2 (05) :361-369
[5]   AN ANALYSIS OF FOLLICLE DEVELOPMENT AND OVUM MATURATION [J].
ERICKSON, GF .
SEMINARS IN REPRODUCTIVE ENDOCRINOLOGY, 1986, 4 (03) :233-254
[6]   Elevated levels of basal estradiol-17β predict poor response in patients with normal basal levels of follicle-stimulating hormone undergoing in vitro fertilization [J].
Evers, JLH ;
Slaats, P ;
Land, JA ;
Dumoulin, JCM ;
Dunselman, GAJ .
FERTILITY AND STERILITY, 1998, 69 (06) :1010-1014
[7]   Non-response to ovarian stimulation in normogonadotrophic, normogonadal women: A clinical sign of impending onset of ovarian failure pre-empting the rise in basal follicle stimulating hormone levels [J].
Farhi, J ;
Homburg, R ;
Ferber, A ;
Orvieto, R ;
BenRafael, Z .
HUMAN REPRODUCTION, 1997, 12 (02) :241-243
[8]   Manipulation of human ovarian function: Physiological concepts and clinical consequences [J].
Fauser, BCJM ;
VanHeusden, AM .
ENDOCRINE REVIEWS, 1997, 18 (01) :71-106
[9]   Oestradiol production by luteinized human granulosa cells:: evidence of the stimulatory action of recombinant human follicle stimulating hormone [J].
Földesi, I ;
Breckwoldt, M ;
Neulen, J .
HUMAN REPRODUCTION, 1998, 13 (06) :1455-1460
[10]  
FRYDMAN R, 1998, HUM REPROD, V13