Long-term FSH therapy in patients with hypersensitive ovaries

Purpose: In this study the effects of long-term/moderate dose (LTMD)- FSH therapy in patients with hypersensitive ovaries were investigated. Patients and study design: A total of 15 treatment cycles in 10 patients was studied. The patients were selected on the basis of previously cancelled cycles due to polyfollicular development in spite of sonomorphologically normal ovaries and standard gonadotropin doses (75-150 IE FSH or hMG/d) (≃ hypersensitive ovaries). Polyfollicular development was defined as ≥10 follicles with 10-12 mm diameter in the follicular phase of the menstrual cycle. To prevent polyfollicular selection in the next treatment cycle the initial FSH dose (37.5-75 IE/d) was maintained until selection of a maximum of three dominant follicles. Thereafter gonadotropin doses were increased gradually. Results: In 9 treatment cycles mono- or bifollicular development was achieved. In one cycle due to selection of 5 follicles, IVF was performed. 5 cycles were cancelled due to polyfollicular selection. Ovarian hyperstimulation syndrome occurred in none of the remaining cycles. The treatment resulted in 7 pregnancies. The outcome of pregnancies was one early abortion, 4 singleton and 2 twin-deliveries with a total of 8 healthy babies born. Conclusion: The LTMD-FSH stimulation protocol has been shown to be safe and effective for patients with hypersensitive ovaries.