A comparison of 3-day and daily follicle-stimulating hormone injections on stimulation days 1–6 in women undergoing controlled ovarian hyperstimulation

Abstract

Objective To evaluate the efficacy of ovarian hyperstimulation by intermittent doses of 450 IU of recombinant human (h)FSH compared with daily 150-IU doses of recombinant hFSH. Design A pilot, open, randomized, parallel-group study. Setting Center for Reproductive Medicine, Düsseldorf, Germany. Patient(s) Infertile women with indication for IVF/intracytoplasmic sperm injection after at least 1 year of unprotected intercourse. Intervention(s) Recombinant hFSH was administered daily or intermittently (3-day intervals) from days 1 to 6 of stimulation and thereafter by daily injection. Main outcome measure(s) Number of preovulatory follicles, retrieved oocytes, two-pronuclei (2PN) zygotes, implantation, and pregnancy rates. Result(s) The number of oocytes in the daily-dose group was significantly greater. There were no significant differences in mean values for number of follicles ≥11 mm (except for day 7) and ≥14 mm, 2PN zygotes, and number of transferred embryos. Implantation and pregnancy rates per cycle were in favor of the intermittent 450-IU dose regimen; implantation rates were 17.0% and 9.8% in the 3-day-dose and daily-dose groups, respectively, and biochemical and clinical pregnancy rates were 33.3% and 15.7% and 25.5% and 13.7%, respectively. Conclusion(s) Intermittent administration of recombinant hFSH significantly reduces the total number of recombinant hFSH injections, compared with a conventional FSH regimen, without detrimental effects on implantation rate or pregnancy rate.