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Human Reproduction, Vol. 14, No. 2, 349-353, February 1999
© 1999 European Society of Human Reproduction and Embryology

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

K. Sengoku1, K. Tamate, Y. Takaoka, M. Horikawa, K. Goishi, H. Komori, R. Okada, K. Tsuchiya and M. Ishikawa

Department of Obstetrics and Gynecology, Asahikawa Medical College, Asahikawa, Japan

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.

Key words: follicle stimulating hormone/low-dose step-up/ovarian hyperstimulation syndrome/unexplained infertility

1 To whom correspondence should be addressed at: Department of Obstetrics and Gynecology, Asahikawa Medical College, Nishikagura 4–5, Asahikawa, Japan 0788510


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