Midcycle Steroidal Levels after Ultra-Low-Dose Pure Follicle-Stimulating Hormone Stimulation versus Human Menopausal Gonadotropin Stimulation in Euestrogenic Women with Follicular Maturation Defects

Abstract

To compare the midcycle endocrine steroidal variables in 32 infertile women with follicular maturation defects treated with ultra-low-dose pure follicle-stimulating hormone (FSH) or human menopausal gonadotropins (hMG). A crossover design was used in which women were randomly assigned to a treatment modality (pure FSH or hMG) in the first cycle, and the alternative treatment was used in the second cycle. In the ultra-low-dose regimen, the dosage began at 1 ampule/day (75 IU) and could increase to a maximum of 1.5 ampules/day. The mean midcycle serum levels determined at the time of peak follicular maturation and before the administration of human chorionic gonadotropin or gonadotropin-releasing hormone for release of oocytes were compared. In the pure FSH cycle, the mean estradiol (E2), progesterone, and luteinizing hormone (LH) levels were 316 +/- 119 pg/mL, 0.6 +/- 0.4 ng/mL, and 23 +/- 22 IU/L, respectively; in the hMG cycle, the mean E2, progesterone, and LH levels were 361 +/- 193 pg/mL, 0.5 +/- 0.4 ng/mL, and 21 +/- 18 IU/L, respectively. Ultra-low-dose gonadotropin therapy produces similar midcycle steroidal levels (E2, progesterone, and LH) whether or not LH is present in addition to FSH in the medications used for follicle stimulation.