Intracytoplasmic sperm injection after follicle stimulation with highly purified human follicle-stimulating hormone compared with human menopausal gonadotropin

Purpose: Our purpose was to compare oocyte nuclear maturation and embryo qu ality after pituitary down-regulation and ovarian stimulation with high Iv purified follicle-stimulating hormone (FSH) or human menopausal gonadotropi n (HMG). Methods: Fifty-Jive patients 37 years of age or younger who were undergoing in vitro fertilization (IVF)-intracytoplasmic sperm injection (ICSI) were evaluated retrospectively. In all cases, male factor was the only indicatio n for treatment, with no female-related factors identified Following pituit ary down-regulaion, patients were stimulated with hMG(n = 20) or highly pur ified FSH (n = 35). Main outcome measures included ovarian response to stim ulation, oocyte maturity, and ICSI fertilization results. Secondary outcome measures included pregnancy rates and outcome. Results: The ovarian response to stimulation was similar for the two groups , as were the percentage of metaphase II oocytes, fertilization and cleavag e rates, and number and quality of transferred and cryopreserved embryos. C ycle outcome was comparable. Conclusions: In normogonadotropic subjects, monocomponent therapy with high ly purified FSH is as effective as hMG in stimulating ovarian follicular de velopment, synchronization of oocyte maturation, and IVF-ICSI outcome. Our findings support the conclusion that the luteinizing hormone component in t he stimulation protocol is unnecessary.