Induction of ovulation with the use of a starting dose of 50 units of recombinant human follicle-stimulating hormone (Puregon*)

Objective: To determine whether a starting dose of 50 units of recombinant FSH (follitropin beta, Puregon; Organon Laboratories Limited, Cambridge, United Kingdom) produces a follicular response in patients with clomiphene citrate-resistant polycystic ovary syndrome (PCOS). Design: Prospective observational study. Setting: Routine clinical practice in a teaching hospital fertility unit. Patient(s): Patients with clomiphene citrate-resistant PCOS who wanted to become pregnant. Intervention(s): Low-dose step-up protocol of SC recombinant FSH administration, monitored prospectively by transvaginal ultrasonography and retrospectively by serum endocrine assays taken at each monitoring visit. Main outcome measure(s): Rate and size of follicular growth, recombinant FSH requirement, E-2 response, ovulation, cycle cancellation, and pregnancy. Result(s): All patients exhibited a follicular response: Six patients ovulated, of whom two conceived and four had their cycles cancelled because of overstimulation. One patient did not ovulate despite the development of a follicle. Conclusion(s): Recombinant FSH can be used successfully to stimulate follicular growth at a starting dose of 50 IU. (C) 1998 by American Society for Reproductive Medicine.