Midcycle steroidal levels after ultra-low-dose pure follicle-stimulating hormone stimulation versus human menopausal gonadotropin stimulation in euestrogenic women with follicular maturation defects.

Objective: 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).

Methods: 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.

Results: 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.

Conclusion: 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.