LOW-DOSE FSH STIMULATION IN POLYCYSTIC-OVARY-SYNDROME - COMPARISON OF3 FSH-PREPARATIONS

In patients with PCOS low dose administration of follicle stimulating hormone is accepted as a safe treatment modality with low risk for an ovarian hyperstimulation syndrome or a multiple pregnancy. In this stu dy we have retrospectively compared the efficacy of 3 different FSH pr eparations in low dose protocols-urinary FSH (FSH), highly purified ur inary FSH (FSHHP) and recombinant FSH (rec. FSH). A total of 68 PCOS-p atients, 36 lean and 32 moderately obese patients, were treated in 116 stimulation cycles. The mean age did not differ between the groups. A mean number of 1.7 cycles per patient was performed. PCOS was diagnos ed in all patients by hormonal and sonographic means. Treatment was pe rformed with daily injections of one ampoule FSH from day 3 onwards. O vulation was induced with 10,000 IU HCG, when the leading follicle exc eeded 16mm in diameter and no more than 3 follicles were seen. The rat e of monofollicular cycles was lowest in obese patients after FSHHP st imulation (30%) and after rec. FSH (66.6% in lean and 58.3% in obese p atients, respectively). The number of FSH ampoules did not differ sign ificantly between the groups. No severe hyperstimulation syndrome was registered. 21 pregnancies were achieved without significant differenc es between the different FSH preparations. Besides two abortions and o ne ectopic implantation, 12 pregnancies were ongoing singleton pregnan cies, 3 twin pregnancies and 3 sets of triplets were noted. In conclus ion, low-dose stimulation with FSH offers a safe and successful treatm ent option in patients with PCOS with an acceptable risk for multiple gestations.