Reversal of persistent anovulation in polycystic ovarian disease by administration of chronic low-dose follicle-stimulating hormone

Induction of Ovulation with Pulsatile Subcutaneous Administration of Human Menopausal Gonadotropin in Patients with Polycystic Ovary Syndrome

“…The use of FSH alone for follicular maturation prior to induction of ovulation with exogenous hCG was noted to be associated with a lower incidence of hyper stimulation than when hMG was used [5,14], In five patients with PCOS who received both the hMG (group I) and FSH regimens (group III), there was no signifi cant difference in the incidence of hyperstimulation be tween the two treatments. The present data do not sup port the suggestion of Kamrava et al [14] that reducing exogenous LH to a minimum might eliminate the risk of hyperstimulation, especially in patients with PCOS. Because the new gonadotropin preparation used in the present study still contained considerable amounts of LH, a more purified FSH may be necessary to reduce the incidence of hyperstimulation in patients with PCOS.…”

“…Successful induction of ovulation with purified prep arations of FSH in patients with PCOS has been re ported in numerous publications [5,14], Berger et al…”

“…The high levels of endogenous LH in patients with PCOS increase the risk of hyperstimulation associated with the use of gonadotropins that are currently available [1,4]. The use of FSH alone for follicular maturation prior to induction of ovulation with exogenous hCG was noted to be associated with a lower incidence of hyper stimulation than when hMG was used [5,14], In five patients with PCOS who received both the hMG (group I) and FSH regimens (group III), there was no signifi cant difference in the incidence of hyperstimulation be tween the two treatments. The present data do not sup port the suggestion of Kamrava et al [14] that reducing exogenous LH to a minimum might eliminate the risk of hyperstimulation, especially in patients with PCOS.…”

Consensus on infertility treatment related to polycystic ovary syndrome

“…In some studies, the limit was four or more follicles >14 mm (82,104). Recently, more stringent criteria have been recommended for ovarian stimulation in unexplained infertility: no more than two follicles >14 mm (105) or no more than three or four follicles >10 mm (106,107).…”

Induction of Ovulation – Past, Present and Future

“…Another use of metrodin is in PCO patients with high LH/FSH ratios [27], A recent study comparing metrodin to HMG in women undergoing in vitro fertili zation demonstrated that both preparations produced similar estradiol and progesterone levels in follicular fluid, but HMG-stimulated follicles contained significantly more testosterone and less androstenedione [29], Patients treated with metrodin in the in vitro fertilization cycles had an increased preg nancy rate. The HMG-associated shift to ward follicular testosterone production and away from androstenedione, which is the predominant estrogen precursor, may im pair potential oocyte development and result in less fertilization, less embryonic implanta tion and lower pregnancy rates [28].…”