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The safety and effectiveness of stepwise and low-dose administration of follicle stimulating hormone in WHO group II anovulatory infertile women: Evidence from a large multicenter study in Spain

  • Clinical Assisted Reproduction
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Abstract

Purpose: Our goal was to investigate the safety, effectiveness, and feasibility for the practicing physician of stepwise and low-dose administration of FSH in WHO group II anovulatory infertile women.

Methods: Infertile female patients (n=234) suffering from WHO group II anovulation, and who failed to became pregnant with clomiphene citrate, were included in a multicenter, prospective, clinical study of treatment with a protocol of chronic low-dose and small incremental rises with urinary purified or highly purified FSH. Follicular development was monitored with ultrasonographic scans.

Results: The 234 patients received a total of 534 cycles of treatment, for a mean number of 2.3 treated cycles per patient. hCG was withheld in 65 (12.2%) cyles because of no response and in 28 (5.2%) cycles because of hyperresponse. Of the remaining 441 cycles, 419 (95%) were ovulatory, and in 198 (47.3%) of these cycles a single dominant follicle developed. There were 93 pregnancies (39.7% per patient), for a cycle fecundity rate of 17.4%. Cumulative conception rate after two treated cycles was 33.5%. There were 14 (15%) pairs of twins and 10 (10.8%) spontaneous miscarriages. The prevalence of complications was low with no cases of severe OHSS. Basal LH/FSH ratio was significantly higher in the pregnant group of patients than in nonpregnant women.

Conclusions: Stepwise and chronic low-dose administration of FSH is a safe and effective method for treatment of WHO group II anovulatory infertility, mainly in those patients having high LH/FSH ratios.

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(on behalf of the multicenter trialists: P. ALVAREZ, Maternidad Santa Cristina, Madrid; J. M. BAJO, Clínica Belén, Madrid; E. BOSCH, Hospital La Fe, Valencia; I. BRUNA, Hospital de Móstoles, Madrid; P. CABALLERO, Hospital Ramón y Cajal, Madrid; J. CALAF, Hospital de la Santa Creu i Sant Pau, Barcelona; I. CANO, Hospital Carlos Haya, Málaga; E. CARRILLO, Hospital Ruber Internacional, Madrid; J. A. DUQUE, Hospital Miguel Servet, Zaragoza; G. FOLGUERA, Hospital de Getafe, Madrid; A. DE LA FUENTE, Fundación Jiménez Díaz, Madrid; C. JIMÉNEZ, Hospital Na Sra. de Sonsoles, Avila; G. LAGUENS, Madrid: E. LÓPEZ, Hospital Virgen de la Arrixaca, Murcia; A. LOZANO, Hospital Provincial, Toledo; A. MATARRANZ, Hospital de Guadalajara, Guadalajara; C. MORENO, IMGI, Madrid; J. NAVA, Hospital Gregorio Marañón, Madrid; M. SANCHIS, Madrid; E. TEMPRANO, Hospital Juan Canalejo, La Coruña; G. VENTURA, Madrid)

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Balasch, J., Tur, R. & Peinado, J.A. The safety and effectiveness of stepwise and low-dose administration of follicle stimulating hormone in WHO group II anovulatory infertile women: Evidence from a large multicenter study in Spain. J Assist Reprod Genet 13, 551–556 (1996). https://doi.org/10.1007/BF02066607

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  • DOI: https://doi.org/10.1007/BF02066607

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