menotropins and Chronic-Disease

To compare the safety and efficacy of recombinant FSH (follitropin beta, Puregon; NV Organon, Oss, the Netherlands) and urinary FSH (urofollitropin, Metrodin; Ares-Serono, Geneva, Switzerland).. A prospective, multicenter, assessor-blind, randomized, clinical trial.. Twelve European infertility clinics.. One hundred seventy-two women (recombinant FSH: n = 105; urinary FSH: n = 67) with clomiphene citrate-resistant normogonadotropic chronic anovulation (World Health Organization group II).. Eligible subjects were randomized (ratio of recombinant to urinary FSH, 3:2) and treated for a maximum of three cycles. A low-dose step-up regimen was used, with 75 IU of FSH given IM daily for a maximum of 14 days and, if needed, weekly increments of half an ampule given thereafter until the threshold dose for follicular development was achieved.. Cumulative ovulation rate after three cycles, total FSH dose, and treatment period needed to achieve ovulation.. The cumulative ovulation rates after three treatment cycles were 95% and 96% for the recombinant and urinary FSH groups, respectively. Overall, ovulation was seen in 155 of 223 treatment cycles (69.5%) in the recombinant FSH group, compared with 92 of 138 treatment cycles (66.7%) in the urinary FSH group. In the first cycle, a statistically significantly lower total dose (750 versus 1,035 IU) and a shorter treatment period (10 versus 13 days) were needed in the recombinant FSH group to reach ovulation. Only one case of ovarian hyperstimulation syndrome led to hospitalization. Two sets of twins (one in each treatment group) and one set of triplets (in the recombinant FSH group) were born.. Recombinant FSH (Puregon) is more efficient than urinary FSH (Metrodin) in inducing follicular development.

Topics: Adult; Anovulation; Chronic Disease; Clomiphene; Drug Resistance; Female; Fertility Agents, Female; Follicle Stimulating Hormone; Gonadotropins; Humans; Menotropins; Ovulation; Prospective Studies; Recombinant Proteins; Reference Values; Time Factors

To evaluate the relative importance of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in follicular development and oocyte fertility in the human species, the use of recombinant human FSH, human menopausal gonadotrophin (HMG), and very highly purified urinary human FSH (FSH-HP) plus oestradiol valerate for ovarian stimulation and in-vitro fertilization (IVF) were compared in three cycles in a woman with isolated congenital gonadotrophin deficiency who had never been treated with ovarian stimulating agents. The total number of ampoules of gonadotrophins used was lower in the HMG treatment cycle. Ovarian response and IVF outcome in the three treatment cycles were as follows: (i) HMG cycle: normal follicular growth, normal pattern of oestradiol and inhibin through the menstrual cycle, high fertilization rate (93%); (ii) recombinant FSH cycle: normal follicular growth, low oestradiol and abnormal inhibin, finally poor rate of fertilization (28%); (iii) FSH-HP plus oestradiol valerate cycle: normal follicular growth, normal pattern of inhibin and poor fertilization rate (27%). Luteal plasma progesterone concentrations were much higher in the HMG treatment cycle. This case shows that FSH is the only factor required in order to induce follicular growth in the human, although LH or a product derived from its action may assist in order to achieve full follicular maturity and oocytes capable of fertilization. Though oestradiol might have a mediatory role in the process of follicular maturation, our results favour a direct primary role of LH in complete maturation of the follicle.

Topics: Adult; Chronic Disease; Drug Therapy, Combination; Estradiol; Female; Fertility; Fertilization in Vitro; Follicle Stimulating Hormone; Humans; Hypogonadism; Luteinizing Hormone; Menotropins; Oocytes; Ovarian Follicle; Recombinant Proteins

Forty-three ovulation cycles stimulated with human menopausal gonadotropin were examined in 31 patients with hypogonadotropic amenorrhea. Peripheral blood estradiol and luteinizing hormone were radioimmunoassayed. The findings indicate the possibility of recovery of adenohypophyseal gonadotropin autosecretion in the presence of human menopausal gonadotropin administration.

Topics: Adult; Amenorrhea; Chronic Disease; Estradiol; Female; Gonadotropins, Pituitary; Humans; Hypopituitarism; Luteinizing Hormone; Menotropins; Ovulation Induction; Stimulation, Chemical

Topics: Adult; Bulgaria; Chorionic Gonadotropin; Chronic Disease; Clomiphene; Female; Hospitals, Maternity; Hospitals, Urban; Humans; Infertility, Female; Insemination, Artificial; Menotropins; Superovulation

Topics: Adult; Amenorrhea; Cervix Mucus; Chronic Disease; Drug Evaluation; Estrogens; Female; Humans; Infertility, Female; Menotropins

Topics: Adult; Amenorrhea; Chronic Disease; Drug Evaluation; Estradiol; Female; Humans; Infertility, Female; Menotropins; Menstruation; Ovarian Follicle; Pregnancy; Time Factors