EXPERIENCE USING PREPARATIONS OF FOLLICLE-STIMULATING-HORMONE ALONE TO STIMULATE THE OVARIES FOR ASSISTED CONCEPTION AFTER PITUITARY DESENSITIZATION AND SIMPLIFIED MANAGEMENT OF TREATMENT

The results are reported of 2,204 cycles of treatment started for in v itro fertilisation and embryo transfer or gamete intrafallopian transf er, during 5 years, 1990-1994, using only follicle-stimulating hormone (FSH) preparations to stimulate the ovaries following pituitary desen sitisation, combined with greatly simplified scheduling and monitoring of treatment. The physiological principles underlying these choices a re discussed. In all women under 40 years of age and men with normal s perm, the use of unpurified urinary FSH in 1990-1993 resulted in oocyt e collection in 94% of cycles started, pregnancy in 29% and live birth s in 23%. Using highly purified urinary FSH (uFSH-HP; Metrodin HP(R)) during 1994, the rate for oocyte collection was 97% and pregnancy 25% (birth rates not yet available). The difference compared with previous years was not significant. A study of 93 first cycles using uFSH-HP s howed that the dosage required was usually (expressed as medians) 24 a mpoules over 12 days (2 ampoules/day) resulting in 9 oocytes (range 2- 36) of which 93% were mature and 64% resulted in cleaving embryos. The results are comparable with the best using human menopausal gonadotro pin or unpurified FSH and classical detailed monitoring.