Open AccessPilot study of the optimal protocol of low dose step‐up follicle stimulating hormone therapy for infertile women
Author(s) -
Matsuzaki Toshiya,
Iwasa Takeshi,
Yanagihara Rie,
Komasaka Mizuki,
Yano Kiyohito,
Mayila Yiliyasi,
Tachibana Ayaka,
Yamamoto Yuri,
Kato Takeshi,
Kuwahara Akira,
Irahara Minoru
Publication year - 2018
Publication title -
reproductive medicine and biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.005
H-Index - 22
eISSN - 1447-0578
pISSN - 1445-5781
DOI - 10.1002/rmb2.12208
Subject(s) - medicine , infertility , ovulation induction , pregnancy rate , ovulation , body mass index , pregnancy , anovulation , gynecology , assisted reproductive technology , follicle stimulating hormone , reproductive medicine , obstetrics , hormone , obesity , luteinizing hormone , insulin resistance , biology , genetics , polycystic ovary
Abstract Purpose To evaluate the optimized protocol of low dose follicle‐stimulating hormone ( FSH ) therapy that has a starting dose of 50 IU/62.5 IU with a small increment dose (12.5 IU) for women with World Health Organization ( WHO ) II ovulatory disorder and unexplained infertility. Methods Anovulatory women with WHO group II ovulatory disorder (ovulation induction [ OI ] patients, n = 29), and with an unexplained infertility (ovarian stimulation [ OS ] patients, n = 21) were enrolled. The protocol of low dose step‐up FSH therapy was optimized for the starting dose as 50 IU (body mass index [ BMI ] < 20 group) and 62.5 IU ( BMI ≥ 20 group) with the increment dose of 12.5 IU . Study outcomes were ovulation, monofollicular development and other variables. Results In the OI patients, the ovulation rate was 100% ( BMI < 20 group) and 90.9% ( BMI ≥ 20 group). Monofollicular development was 80.0% ( BMI < 20) and 77.3% ( BMI ≥ 20). The pregnancy rate was 60% (3/5 BMI < 20) and 18.2% (4/22 BMI ≥ 20). There was no multiple pregnancy. In the OS patients, the ovulation rate was 100%. Monofollicular development was 85.7% (BMI < 20) and 76.6% (BMI ≥ 20). No pregnancy was achieved in the OS patients. Conclusion Optimized protocol of low dose FSH therapy setting a starting dose 50 IU /62.5 IU by BMI with an increment dose of 12.5 IU was safe and highly effective in WHO group II anovulatory patients. However, this protocol seemed uneffective for patients with unexplained infertility.