Ovarian Stimulation in Obese and Non-obese Polycystic Ovary Syndrome Using a Low-dose Step-up Regimen with Two Different Starting Doses of Recombinant Follicle-stimulating Hormone

Yildizhan R., Adali E., Kolusari A., Kurdoglu M., Yildizhan B., Sahin H. G., ...More

JOURNAL OF INTERNATIONAL MEDICAL RESEARCH, vol.36, no.6, pp.1197-1204, 2008 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 36 Issue: 6
  • Publication Date: 2008
  • Doi Number: 10.1177/147323000803600605
  • Journal Name: JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1197-1204
  • Keywords: POLYCYSTIC OVARY SYNDROME, RECOMBINANT FOLLICLE-STIMULATING HORMONE, LOW-DOSE STEP-UP REGIMEN, OBESITY, OVULATION INDUCTION, INSULIN-RESISTANCE, OVULATION INDUCTION, WOMEN, GONADOTROPINS
  • Marmara University Affiliated: Yes

Abstract

Sixty-seven infertile women with polycystic ovary syndrome (PCOS) were divided into two groups, obese and non-obese, according to their body mass index. Waist-to-hip ratio, insulin resistance, total testosterone and dehydroepiandrosterone sulphate levels were significantly elevated in obese, compared with non-obese, patients. Both groups were treated with a low-dose step-up protocol of recombinant follicle-stimulating hormone (rFSH) with a starting dose of 50 IU/day and, every third day, a 25-IU increase in the dose until the appropriate dose was achieved for each individual, up to a maximum of 175 IU/day. In the obese group only, repeat therapy commenced in the second ovulatory cycle in women who had not become pregnant, however a starting dose of 75 IU/day was then used, with incremental and maximum dose as before. The results of the starting dose of 75 IU/day rFSH were compared with the results of a 50 IU/day rFSH starting dose in the obese group. A starting dose of 50 IU/day rFSH in a low-dose step-up regimen was found to be effective, safe and well-tolerated for inducing follicular development in non-obese infertile women with PCOS. However, for obese PCOS patients, a starting dose of 75 IU/day rFSH is recommended.