The clinical efficacy of low-dose step-up follicle stimulating hormone administration for treatment of unexplained infertility

Kazuo Sengoku, Kenichi Tamate, Y. Takaoka, Michiharu Horikawa, Keiji Goishi, Hisakazu Komori, Rie OKADA, Koki Tsuchiya, Masahiko Ishikawa
In: Human Reproduction · 1999 · vol. 14(2) , pp. 349–353 · doi:10.1093/humrep/14.2.349 · PMID:10099977 · W1973285147
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A low-dose step-up FSH protocol with IUI showed similar pregnancy rates but significantly reduced OHSS incidence compared to conventional FSH with IUI in unexplained infertility patients.

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Abstract

The present study was designed to compare the clinical efficacy of low-dose step-up follicle stimulating hormone (FSH) administration with conventional FSH protocol (FSH was injected daily starting with a dose of 150 IU), both combined with intrauterine insemination (IUI), for the treatment of unexplained infertility. A total of 97 unexplained infertility couples was randomly assigned to one or other of the two treatment groups, either conventional FSH with IUI (48 patients) or low-dose step-up FSH with IUI (49 patients), and only the first treatment cycle was evaluated in each protocol. The difference in pregnancy rates per cycle was not statistically significant between the low-dose FSH group and the conventional group [seven of 49 (14.3%) and seven of 48 (14.6%) respectively]. A significant reduction in the incidence of ovarian hyperstimulation syndrome (OHSS) was observed in the low-dose group (8.3% versus 27.1%, P < 0.05). The incidence of moderate OHSS requiring hospitalization was reduced significantly in the low-dose group (low-dose 0% versus conventional 16.7%, P < 0.01). However, the low-dose protocol did not completely prevent multiple pregnancies. Our results suggest that the low-dose step-up FSH treatment appeared to be useful for the treatment of unexplained infertility because of the high pregnancy rates and the significant decrease in the incidence of OHSS.

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infertility

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