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Human Reproduction, Vol. 16, No. 9, 1875-1879, September 2001
© 2001 European Society of Human Reproduction and Embryology

Rescue of IVF cycles by HMG in pituitary down-regulated normogonadotrophic young women characterized by a poor initial response to recombinant FSH

Giuseppe De Placido1, Antonio Mollo1, Carlo Alviggi1,4, Ida Strina1, Maria Teresa Varricchio1, Antonio Ranieri1, Nicola Colacurci2, Achille Tolino1 and Martin Wilding1,3

1 Dipartimento Clinico di Emergenza Ostetrica, Ginecologica e Medicina della Riproduzione, Area Funzionale di Medicina della Riproduzione ed Endoscopia Ginecologica, Università degli Studi di Napoli `Federico II', Naples, 2 Istituto di Clinica Ginecologia, II Università di Napoli, Largo Madonna delle Grazie, 80128 Naples and 3 Centre for Reproductive Biology Clinica Villa del Sole,Via Manzoni, 15, 80126 Naples, Italy

BACKGROUND: The aim of this study was to investigate the effects of adding human menopausal gonadotrophin (HMG) during controlled ovarian stimulation in normoovulatory normogonadotrophic patients showing an initial suboptimal response to a standardized long protocol therapy with recombinant FSH (rFSH) (300 IU/day). METHODS: A total of 43 such patients were randomized in two groups. In Group A, 150 IU rFSH was substituted by 150 IU HMG after day 8 of stimulation. The stimulation protocol of Group B involved a simple increase of the daily rFSH dose to 375 IU after day 8. A total of 40 BMI and age matched patients with an optimal ovarian response formed the control group (Group C). RESULTS: The mean Group A serum concentration of oestradiol on the day of HCG administration and average number of oocytes retrieved were significantly higher than Group B (P < 0.001) and equivalent to Group C. A total of 10 pregnancies (50%) in Group A, 8 (34.8%) in Group B and 19 (47.5%) in the control group were achieved. CONCLUSIONS: The data suggest that LH supplementation improves the ovarian outcome in patients characterized by an inadequate initial response to rFSH therapy in a long protocol.

Key words: gonadoptrophin/human oocyte/luteinizing hormone/pituitary/poor responders

4 To whom correspondence should be addressed. E-mail: calviggi{at}hotmail.com


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