Human Reproduction, Vol. 16, No. 5, 846-854,
May 2001
© 2001 European Society of Human Reproduction and Embryology
Low-dose exogenous FSH initiated during the early, mid or late follicular phase can induce multiple dominant follicle development
1 Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, 2 Department of Internal Medicine and 3 Center for Clinical Decision Sciences, Department of Public Health, Erasmus University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
This prospective, randomized trial in normo-ovulatory women was designed to test whether administration of low-dose exogenous FSH initiated during the early, mid to late follicular phase can induce multiple dominant follicle development. Forty normal weight women (age 19–35 years, cycle length 25–32 days) participated. A fixed dose (75 IU/day) of recombinant FSH was started on either cycle day 3 (n = 13), 5 (n = 13) or 7 (n = 14) until the induction of ovulation with human chorionic gonadotrophin. Frequent transvaginal ultrasound scans and blood sampling were performed. Multifollicular growth occurred in all groups (overall in 60%), although day 7 starters showed less multifollicular growth. Age, cycle length and initial FSH and inhibin B concentrations were similar between subjects with single or multiple follicle development. However, for all women the lower the body mass index (BMI), the more follicles emerged (r = –0.44, P = 0.007). If multifollicular growth occurred, the length of the luteal phase was reduced (P = 0.002) and midluteal serum concentrations of LH (P = 0.03) and FSH (P = 0.004) were decreased and oestradiol (P = 0.002) and inhibin A (P = 0.01) were increased. In conclusion, interference with decremental serum FSH concentrations by administration of low dose FSH starting on cycle day 3, 5 or as late as day 7, is capable of disrupting single dominant follicle selection. The role of BMI in determining ovarian response suggests that differences in pharmacokinetics of exogenous FSH are involved. Multifollicular growth per se has a distinct effect on luteal phase characteristics. These observations may be relevant for the design of mild ovarian stimulation protocols.
Key words: follicle development/FSH/luteal phase/menstrual cycle/ovarian stimulation
4 To whom correspondence should be addressed. E-mail: fauser{at}gyna.azr.nl
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M.F.G. Verberg, M.J.C. Eijkemans, E.M.E.W. Heijnen, F.J. Broekmans, C. de Klerk, B.C.J.M. Fauser, and N.S. Macklon Why do couples drop-out from IVF treatment? A prospective cohort study Hum. Reprod., September 1, 2008; 23(9): 2050 - 2055. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Diedrich, B.C.J.M. Fauser, P. Devroey, G. Griesinger, and on behalf of the Evian Annual Reproduction (EVAR) The role of the endometrium and embryo in human implantation Hum. Reprod. Update, July 1, 2007; 13(4): 365 - 377. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.F.G. Verberg, M.J.C. Eijkemans, N.S. Macklon, E.M.E.W. Heijnen, B.C.J.M. Fauser, and F.J. Broekmans Predictors of low response to mild ovarian stimulation initiated on cycle day 5 for IVF Hum. Reprod., July 1, 2007; 22(7): 1919 - 1924. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Kevenaar, A. P.N. Themmen, J. S.E. Laven, B. Sonntag, S. L. Fong, A. G. Uitterlinden, F. H. de Jong, H. A.P. Pols, M. Simoni, and J. A. Visser Anti-Mullerian hormone and anti-Mullerian hormone type II receptor polymorphisms are associated with follicular phase estradiol levels in normo-ovulatory women Hum. Reprod., June 1, 2007; 22(6): 1547 - 1554. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Cedrin-Durnerin, N. Massin, J. Galey-Fontaine, H. Bry-Gauillard, M. Roger, N. Lahlou, and J.N. Hugues Timing of FSH administration for ovarian stimulation in normo-ovulatory women: comparison of an early or a mid follicular phase initiation of a short-term treatment Hum. Reprod., November 1, 2006; 21(11): 2941 - 2947. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. G M Beckers, P. Platteau, M. J Eijkemans, N. S Macklon, F. H de Jong, P. Devroey, and B. C J M Fauser The early luteal phase administration of estrogen and progesterone does not induce premature luteolysis in normo-ovulatory women. Eur. J. Endocrinol., August 1, 2006; 155(2): 355 - 363. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.C. Tarlatzis, B.C. Fauser, E.M. Kolibianakis, K. Diedrich, P. Devroey, and , On Behalf of the Brussels GnRH Antagonist Consen GnRH antagonists in ovarian stimulation for IVF Hum. Reprod. Update, July 1, 2006; 12(4): 333 - 340. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. S. Macklon, R. L. Stouffer, L. C. Giudice, and B. C. J. M. Fauser The Science behind 25 Years of Ovarian Stimulation for in Vitro Fertilization Endocr. Rev., April 1, 2006; 27(2): 170 - 207. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. R. Greb, K. Grieshaber, J. Gromoll, B. Sonntag, E. Nieschlag, L. Kiesel, and M. Simoni A Common Single Nucleotide Polymorphism in Exon 10 of the Human Follicle Stimulating Hormone Receptor Is a Major Determinant of Length and Hormonal Dynamics of the Menstrual Cycle J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4866 - 4872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. P Hohmann, J. S E Laven, F. H de Jong, and B. C J M Fauser Relationship between inhibin A and B, estradiol and follicle growth dynamics during ovarian stimulation in normo-ovulatory women Eur. J. Endocrinol., March 1, 2005; 152(3): 395 - 401. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. B. Inge, P. R. Brinsden, and K. T. Elder Oocyte number per live birth in IVF: were Steptoe and Edwards less wasteful? Hum. Reprod., March 1, 2005; 20(3): 588 - 592. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. G.M.G.J. Mulders, J. S.E. Laven, M. J.C. Eijkemans, F. H. de Jong, A. P.N. Themmen, and B. C.J.M. Fauser Changes in anti-Mullerian hormone serum concentrations over time suggest delayed ovarian ageing in normogonadotrophic anovulatory infertility Hum. Reprod., September 1, 2004; 19(9): 2036 - 2042. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. S. MACKLON and B.C. J.M. FAUSER Mild Stimulation in In Vitro Fertilization Ann. N.Y. Acad. Sci., November 1, 2003; 997(1): 105 - 111. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. G. M. Beckers, N. S. Macklon, M. J. Eijkemans, M. Ludwig, R. E. Felberbaum, K. Diedrich, S. Bustion, E. Loumaye, and B. C. J. M. Fauser Nonsupplemented Luteal Phase Characteristics after the Administration of Recombinant Human Chorionic Gonadotropin, Recombinant Luteinizing Hormone, or Gonadotropin-Releasing Hormone (GnRH) Agonist to Induce Final Oocyte Maturation in in Vitro Fertilization Patients after Ovarian Stimulation with Recombinant Follicle-Stimulating Hormone and GnRH Antagonist Cotreatment J. Clin. Endocrinol. Metab., September 1, 2003; 88(9): 4186 - 4192. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. P. Hohmann, N. S. Macklon, and B. C. J. M. Fauser A Randomized Comparison of Two Ovarian Stimulation Protocols with Gonadotropin-Releasing Hormone (GnRH) Antagonist Cotreatment for in Vitro Fertilization Commencing Recombinant Follicle-Stimulating Hormone on Cycle Day 2 or 5 with the Standard Long GnRH Agonist Protocol J. Clin. Endocrinol. Metab., January 1, 2003; 88(1): 166 - 173. [Abstract] [Full Text] [PDF]
|
|