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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.

Pilot study of the optimal protocol of low dose step‐up follicle stimulating hormone therapy for infertile women