Recombinant human follicle-stimulating hormone for ovulation induction in polycystic ovary syndrome:: A prospective, randomized trial of two starting doses in a chronic low-dose step-up protocol

Purpose: The aim was to compare the follicular response to 37.5 and 50 IU of recombinant follicle-simulating hormone (FSH) as starting doses for ovulation induction in patients with polycystic ovary syndrome (PCOS). Methods: Prospective, randomized crossover study including 15 women with clomiphene citrate-resistant chronic anovulatory infertility. Patients were treated with subcutaneous recombinant FSH at starting doses of 37.5 IU and 50 IU, respectively according to a low-dose step-up protocol. Each woman received both treatments, in a randomized or der, with an interval of greater than or equal to1 month between treatments. Results: All treatment cycles were ovulatory after an appropriate follicular response and hormone levels were similar with both treatments, althorlgh the total quantity of FSH required and the mean daily dose required to induce identical follicular development were significantly lower with a starting dose of 37.5 IU FSH. The mean duration of treatment to achieve ovulation was approximately 13 days with both treatments but treatment periods greater than or equal to 20 days were required in some patients. Conclusions: In women with PCOS, a starting dose of 37.5 IU recombinant FSH may be adequate to induce follicular growth. However; the rise of low stal ring doses mcay result in some cases in increased treatment periods and need for monitoring.