A randomized, double-blind, multicenter study comparing a starting dose of 100 IU or 200 IU of recombinant follicle stimulating hormone (Puregon) in women undergoing controlled ovarian hyperstimulation for IVF treatment.

PURPOSE: To compare the efficiency and efficacy of two starting doses of recombinant FSH (follitropin-beta, Puregon) in women undergoing IVF treatment. METHODS: This prospective, randomized, double-blind, multicentric (N = 6) study included 192 women undergoing IVF using the long protocol of GnRH agonist who received either 100 IU or 200 IU of r-FSH per day. Gonadotropin dose adjustment was allowed after day 4 of stimulation. RESULTS: The average (SD) number of oocytes retrieved was 10.9 (5.4) and 12.2 (5.6) in the 100 IU and 200 IU group respectively (p = 0.067). The total doses of Puregon administered were 1887 IU and 2559 IU in the 100 IU and 200 IU group respectively. The number of transferable embryos, and the rates of pregnancies, cancelled cycles, miscarriages and adverse events including OHSS were comparable between the two groups. CONCLUSIONS: Women undergoing IVF have similar outcomes whether recombinant FSH is commenced in a dose of 100 IU or 200 IU for the first 4 days of stimulation.

Randomized, controlled trial of priming with 10,000 IU versus 20,000 IU of human chorionic gonadotropin in women with polycystic ovary syndrome who are undergoing in vitro maturation.

Preretrieval priming with 10,000 IU hCG can improve oocyte maturation rates in vitro for women undergoing in vivo maturation treatment, though the optimum dose is unknown. This prospective, randomized, controlled trial demonstrated no improvement in oocyte maturation rates with 20,000 IU of hCG compared with 10,000 IU of hCG and therefore no benefit of the higher dose.

In vitro maturation and fertilization of oocytes from unstimulated ovaries: predicting the number of immature oocytes retrieved by early follicular phase ultrasonography.

OBJECTIVE: To select women who will benefit most from in vitro maturation (IVM) of oocytes treatment, this study was undertaken to examine the ability of a transvaginal ultrasonography to predict the number of immature oocytes collected from unstimulated ovaries. STUDY DESIGN: The relationship between the number of immature oocytes retrieved and the pregnancy rate was assessed in 189 IVM treatment cycles. In 96 consecutive cycles, an early follicular phase transvaginal ultrasonographic measurement of the antral follicle count (AFC), ovarian volume, and peak ovarian stromal blood flow velocity (Vmax) was performed, and the results were correlated with the number of immature oocytes. RESULTS: The clinical pregnancy rate increased significantly with the number of oocytes retrieved (P =.02) and was 26.8% (15/56) in those with >10 immature oocytes. The AFC, ovarian volume, and ovarian stromal Vmax were all predictive of the number of oocytes retrieved, but when the other factors were controlled by multiple regression analysis the AFC was the only significant predictor (P <.001). CONCLUSIONS: Pregnancy rates after IVM correlate with the number of immature oocytes retrieved. This is best predicted by an ultrasonographic assessment of the AFC.