Human Reproduction, Vol. 16, No. 8, 1676-1681,
August 2001
© 2001 European Society of Human Reproduction and Embryology
A prospective, randomized comparison of two starting doses of recombinant FSH in combination with cetrorelix in women undergoing ovarian stimulation for IVF/ICSI
1 Fertilitetscentrum, Carlander's Hospital, Göteborg, Sweden, 2 The IVF Unit, Department of Obstetrics/Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden and 3 Serono International, 15bis Chemin des Mines, 1202 Geneva, Switzerland
BACKGROUND: A prospective randomized study was carried out in two centres to compare the number of oocytes retrieved after two different starting doses of recombinant human FSH (rhFSH) (Gonal-F®) in women undergoing ovarian stimulation for IVF/intracytoplasmic sperm injection (ICSI) cycles using the multiple dose regimen of the gonadotrophin-releasing hormone (GnRH) antagonist cetrorelix (Cetrotide®) to prevent induction of the premature LH surge. METHODS: Sixty women were randomized to receive rhFSH 150 IU (`low'), and 60 women to receive rhFSH 225 IU (`high') as the starting dose for the first 5 days of stimulation. From stimulation day 6 and onwards, including the day of human chorionic gonadotrophin (HCG) administration, the women received 0.25 mg of cetrorelix as a daily dose. The primary endpoint was the number of oocytes retrieved. RESULTS: The mean number (± SD) of oocytes was 9.1 ± 4.4 and 11.0 ± 4.6 in the `low' and `high' groups respectively (P = 0.024). The mean number of 75 IU ampoules of rhFSH was significantly lower in the `low' group (23.0 ± 6.3 versus 30.5 ± 5.6, P < 0.0001). The ongoing pregnancy rate per started cycle and per embryo transfer were 25.9 and 28.8% versus 25.4 and 26.8% respectively in the `low' and `high' rhFSH groups (P = NS). CONCLUSIONS: When using a starting dose of 225 IU rhFSH combined with the multiple dose of 0.25 mg cetrorelix from stimulation day 6, significantly more oocytes were obtained than with a starting dose of 150 IU rhFSH.
Key words: assisted reproduction/GnRH antagonist/ICSI/IVF/ovarian stimulation/recombinant FSH
4 To whom correspondence should be addressed at: Fertilitetscentrum, Box 5418, S-402 29, Göteborg, Sweden.E-mail: matts.wikland{at}fcivf.com
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