Increasing the daily dose of recombinant follicle stimulating hormone (Puregon((R))) does not compensate for the age-related decline in retrievable oocytes after ovarian stimulation

A prospective, randomized, double-blind, multicentre (n = 6) study was cond ucted to compare the influence of either a 150 or 250 IU daily fixed-dose r egimen of recombinant follicle stimulating hormone (FSH, Puregon(R)) on the number of oocytes retrieved and the total dose used in down-regulated wome n between 30 and 39 years of age undergoing ovarian stimulation. In all, 13 8 women were treated with recombinant FSH, 67 with 150 IU and 71 with 250 I U, The number of oocytes retrieved in the low-dose group was 9.1 compared t o 10.6 in the high-dose group (not significant). In the 30-33 gears of age class receiving the 250 ni dose, a surplus of 4.2 oocytes (14.8 versus 10.6 ) was found, whereas in the 37-39 age class nearly one oocyte more was retr ieved in the 150 TU group (8.1 versus 7.4), The total dose used to reach th e criterion for human chorionic gonadotrophin (HCG) administration was 1727 IU for the women treated with 150 IU daily and 2701 IU for the 250 IU trea ted women (P < 0.001). No significant relationships were found between seru m FSH concentrations as obtained in the early follicular phase and the numb er of oocytes collected, or the total dose. It is concluded that in women b etween 30 and 39 years of age, the decline in number of oocytes retrieved w ith increasing age cannot be overcome by augmenting the daily dose of recom binant FSH from 150 to 250 IU.