Recombinant follicle-stimulating hormone in the treatment of patients with history of severe ovarian hyperstimulation syndrome

Objective: To compare the low-dose recombinant FSH and hMG protocols in treatment of patients with history of severe ovarian hyperstimulation syndrome (OHSS). Design: A prospective study on 22 patients with history of severe OHSS. Group A (n = 14) was treated with low-dose recombinant FSH in 40 cycles and group B (n = 8) was treated with low-dose hMG in 26 cycles. Setting: The Egyptian IVF-ET Center, Cairo, Egypt. Patient(s): Twenty-two patients with a history of severe OHSS. Intervention(s): Ovulation induction. Main Outcome Measure(s): Estradiol, number of follicles, number of hMG ampules, pregnancy rate (PR), and the development of OHSS. Result(s): The cancellation rate, mean E(2) level on day of hCG, mean number of days of stimulation, and the mean number of ampules per cycle were 10%, 523 +/- 166 pg/mL (conversion factor to SI unit, 3.671), 17.8 +/- 5.4, and 19 +/- 6.5 in group A and 19.2%, 554 +/- 152 pg/mL, 14.6 +/- 2.5, and 16.1 +/- 3.6 in group B, respectively. Treatment resulted in eight pregnancies (20% per cycle) and two abortions (25%) in group A. In group B, four pregnancies resulted (15.4% per cycle) and two patients aborted (50%). No cases of OHSS developed in both groups. There were no significant differences in all parameters between the two groups. Conclusion(s): Recombinant FSH low-dose protocol proved to be as effective as low-dose hMG in producing reasonable ovulation and PRS in polycystic ovary syndrome patients with a history of severe OHSS and the protocol was safe concerning the risk of development of OHSS.