OVARIAN STIMULATION WITH LOW-DOSE PURE FOLLICLE-STIMULATING-HORMONE IN POLYCYSTIC OVARIAN SYNDROME ANOVULATORY PATIENTS - EFFECT OF LONG-TERM-PRETREATMENT WITH GONADOTROPIN-RELEASING-HORMONE ANALOG

A randomised clinical trial was performed to evaluate the effect of a 3-month gonadotrophin-releasing-hormone analogue (GnRH-a) in one cycle of ovulation induction with low-dose pure follicle-stimulating hormon e (pFSH) in patients with polycystic ovarian syndrome (PCOS) anovulati on. Twenty patients with chronic anovulation due to PCOS were randomis ed to ovulation induction with pFSH administered in a low-dose schedul e with (10 patients) and without(10 patients) a 3-month pretreatment w ith GnRH-a. Ultrasound scan only monitoring of follicular growth, eval uation of plasmatic oestradiol at the day of triggering of ovulation w ith human chorionic gonadotrophin 5,000 IU and evaluation of plasmatic progesterone 8 days after mere the main outcome measures. Ovulation o ccurred in 9 patients treated with pFSH and in 2 patients treated with GnRH-a plus pFSH. Five pregnancies in the pFSH group and no pregnancy in the GnRH-a group were obtained. Five cycles were stopped due to mu ltifollicular growth in the GnRH-a group and 1 in the pFSH group. Pret reatment with a 3-month administration of a GnRH-a did nor improve the ovulation rate and pregnancy rate in PCOS patient ovulation induction with low-dose pFSH.