Ovulation induction with low dose alternate day recombinant follicle stimulating hormone (Puregon)

Abstract

We investigated whether a recombinant follicle stimulating hormone (FSH) (Puregon^®) can be administered less frequently and at lower doses during ovulation induction than is current practice. Patients (20–35 years, body mass index 2) with infertility and chronic anovulation secondary to polycystic ovarian syndrome and resistant to previous clomiphene treatment received (Puregon^®; 100 IU, n = 17 patients, or 50 IU, n = 10 patients) on alternate days. After 2 weeks and in the absence of follicular recruitment, doses were increased stepwise at weekly intervals (50 IU/alternate days). Twenty-two cycles out of 27 were ovulatory. There were six pregnancies, five from Puregon^® (100 IU) and one from Puregon^® (50 IU); four pregnancies proceeded to term. The duration of stimulation (mean, range) with Puregon^® (100 IU) was 16.4, 7–29 and Puregon^® (50 IU) 19.1, 8–38 days. The gonadotrophin doses administered (mean; range) were 689, 200–1800 IU (Puregon^® 50 IU) and 939, 400–2300 IU (Puregon^® 100 IU). We conclude that low dose alternate day Puregon^® treatment is suitable for this difficult patient group.