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Human Reproduction, Vol. 11, No. 3, pp. 474-477, 1996
© 1996 European Society of Human Reproduction and Embryology

Controlled ovarian stimulation using highly purified FSH results in a lower serum oestradiol profile in the follicular phase as compared with HMG

Gabriel Fried1, J. Harlin, G. Csemiczky and H. Wramsby

Reproductive Medical Center, Department of Women and Child Health, Division of Obstetrics and Gynecology, Karolinska Hospital S171 76 Stockholm, Sweden

Correspondence: 1To whom correspondence should be addressed

We have examined the efficacy of highly purified follicle stimulating hormone (FSH-HP) for controlled ovarian stimulation in our in-vitro fertilization (IVF) programme, and compared the results obtained with this preparation with those using human menopausal gonadotrophin (HMG) in 15 patients who had received treatment with both FSH-HP and HMG in consecutive cycles (n = 39). No differences were found in the duration of stimulation, which was 13.9 days (HMG) as compared with 143 days (FSH-HP). However, in the FSH-HP-treated cycles we found a striking difference in the rise of serum oestradiol, which was significantly lower than in HMG-treated cydes (2953 ± 938 pmol/1 as compared with 6349 ± 3683 pmol/1 on the day before ovum retrieval). Number and size of follicles were similar in the two groups, as were oocyte characteristics. Increase in endometrial thickness at two days prior to ovum retrieval was slightly higher after HMG. The results indicate that in combination with a long gonadotro-phin-releasing hormone agonist (GnRHa) protocol, pure FSH is sufficient for adequate follicle recruitment and growth. However, since FSH-HP resulted in markedly reduced concentrations of serum oestradiol as compared to HMG cycles, IVF programmes using repeated oestradiol measurements to decide the day of ovum retrieval must take this into consideration in order not to prolong the stimulation unnecessarily.

Key words: FSH/HMG/IVF/oestradiol/ovary

Submitted on March 13, 1995; accepted on November 11, 1995.


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Z. Kilani, A. Dakkak, S. Ghunaim, G.E. Cognigni, C. Tabarelli, L. Parmegiani, and M. Filicori
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