A randomized prospective cross-over study of highly purified follicle-stimulating hormone and human menopausal gonadotrophin for ovarian hyperstimulation in women aged 37-41 years

Purpose: In the present study, we investigated the benefits of highly purif ied FSH (H.P. FSH) in comparison with human menopausal gonadotrophin (hMG) in IVF patients aged 37-41 years. Methods: Twenty patients experienced within a period of four months both pr eparations in subsequent cycles through a prospective randomized cross-over design. A standard hormonal treatment consisting of a flare-up protocol us ing gonadotrophin-releasing hormone agonist (GnRHa) in combination with the same starting dose of H.P. FSH or hMG was used in all cycles. Results: Cycles stimulated with H.P. FSH resulted in a significantly higher mean number (10.3 +/- 3) of ovocytes retrieved with a significantly shorte r (13 +/- 2.3 days) duration of stimulation compared to cycles treated with hMG [mean number of oocytes 7.3. +/- 5 (P < 0.01) and mean duration of sti mulation 14.7 +/- 3.9 days (P < 0.02)]. No detrimental effect of basal or e xogenous LH on oocyte quality was observed in our study. Conclusions: In our experience, H.P. FSH preparations seemed to be more eff ective than hMG preparations for ovarian stimulation in this group of women aged 37-41 years.