The use of a starting dose of recombinant follicle stimulating hormone forcontrolled ovarian hyperstimulation: a randomized pilot study

The aim of this study war to compare the costs and effects of two different controlled ovarian hyperstimulation treatments: a starting dose of recombi nant follicle stimulating hormone (FSH)followed by highly purified urinary FSH; or highly purified urinary FSH alone. Forty-six infertile patients, after being given luteal gonadotropin-releasi ng hormone (GnRH) agonist, were randomly assigned to the two stimulation pr otocols. During the ovarian stimulation regimen the patients underwent tran svaginal ultrasonographic evaluation of follicular number and sire. The ret rieved oocytes were classified on the basis of the criteria of Acosta and c olleagues. To study the impact of embryo quality on implantation, the embry os were graded morphologically before replacement. Pregnancy rates were asc ertained and the casts of the two different protocols were analyzed. The number of days of FSH stimulation and the cost of gonadotropin treatmen t were similar in both groups. The number of follicles > 17 mm in size, the number of collected oocytes, and pregnancy rate per cycle were significant ly higher in the group partially treated with recombinant gonadotropin. We conclude from these results that the use of recombinant FSH in the early ph ase of controlled ovarian hyperstimulation leads to significant improvement s in pregnancy rate per cycle without increasing the costs of treatment.