A COMPARATIVE-STUDY OF FIXED-DOSE, STEP-DOWN, AND LOW-DOSE STEP-UP REGIMENS OF HUMAN MENOPAUSAL GONADOTROPIN FOR PATIENTS WITH POLYCYSTIC-OVARY-SYNDROME

Objective: To compare the efficacy and safety of the fixed-dose, the s tep-down, and the low-dose step-up regimens of hMG for women with poly cystic ovary syndrome (PCOS). Design: Prospective randomized study. Se tting: Gunma University School of Medicine, Maebashi, Japan. Patient(s ): Thirty-seven women with PCOS. Intervention(s): The fixed-dose, the step-down, and the low-dose step-up regimens were administered. Main O utcome Measure(s): The number of growing follicles and serum hormone l evels. Result(s): Serum FSH levels on the day of hCG administration we re significantly higher in the fixed-dose regimen group than in the st ep-down and the low-dose step-up regimen groups, and the number of gro wing follicles (greater than or equal to 11 mm) in the low-dose step-u p regimen group was significantly smaller than in the fixed-dose regim en group. On the 7th day after hCG administration. the maximal diamete r of the ovaries in the low-dose step-up regimen group was significant ly smaller than in the fixed-dose and the step-down regimen groups, an d the risk of excessive ovarian enlargement (greater than or equal to 70 mm) was significantly lower in the low-dose step-up regimen group t han in the tired-dose regimen group, Conclusion: The low-dose step-up regimen of hMG for patients with PCOS may he the safest protocol among the three stimulation regimens for reducing multiple follicular devel opment. (Fertil Steril(R) 1998;70:840-6, (C) 1998 by American Society for Reproductive Medicine.).