Urinary follicle-stimulating hormone (FSH) versus recombinant FSH in clomiphene citrate-resistant, normogonadotropic, chronic anovulation: a prospective randomized study

Objective: To compare the efficacy and safety of urinary FSH and recombinan t FSH for ovulation induction in patients with clomiphene citrate-resistant , normogonadotropic, chronic anovulation. Design: Prospective, randomized trial. Setting: University-based infertility clinic. Patient(s): Fifty-one women. Intervention(s): Subjects were randomized to receive either urinary FSH (35 patients, 64 cycles) or recombinant FSH (16 patients, 32 cycles). A maximu m of three cycles using the low-dose step-up protocol with the same gonadot ropin were undertaken. Main Outcome Measure(s): Cumulative ovulation and pregnancy rates after thr ee cycles, total gonadotropin dose, duration of stimulation, and single fol licle development rate. Result(s): Cumulative ovulation rates were 89.3% and 93.1% for the urinary FSH and recombinant FSH groups, respectively. The threshold and total doses of FSH and the duration of stimulation were similar between the two groups . Significantly more single follicle development was noted in the recombina nt FSH group. The respective clinical pregnancy rates per noncanceled cycle s in the urinary FSH and recombinant FSH groups were 23.2% and 27.6%. There were three sets of twins in the urinary FSH group. No case of ovarian hype rstimulation syndrome was encountered. Conclusion(s): Urinary FSH and recombinant FSH are both efficient and safe for inducing ovulation with the low-dose step-up protocol. (C) 1999 by Amer ican Society for Reproductive Medicine.