A comparative randomized multicentric study comparing the step‐up versus step‐down protocol in polycystic ovary syndrome
S. Christin‐Maitre,J.N. Hugues +1 more
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TL;DR: The step-up protocol using rFSH (Puregon), is more efficient in obtaining a monofollicular development and ovulation than the step-down protocol, in women with CC-resistant polycystic ovaries.
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Abstract: BACKGROUND: The aim of the study was to evaluate follicular development and ovulation comparing the lowdose step-up and the step-down protocols, in women with clomiphene citrate (CC)-resistant polycystic ovaries. METHODS: Eighty-three women were randomized, and treated with recombinant (r) FSH (Puregon ‚ ) using either the step-up (n = 44) or step-down (n = 39) protocol. They were followed up for three cycles unless pregnancy occurred. RESULTS: Monofollicular development occurred in 68.2% of the 85 cycles in the step-up group, as compared with 32% of the 72 cycles in the step-down group (P < 0.0001). Hyperstimulation was statistically less frequent using the step-up procedure (4.7 versus 36%, P < 0.0001). Both protocols used the same number of FSH units per cycle (951 6 586 versus 967 6 458 in step-up and step-down respectively, P = not significant). However, the duration of ovarian stimulation was statistically different (15.2 6 7.0 days in step-up versus 9.7 6 3.1 in step-down, P < 0.001). Ovulation was observed in 70.3% of the cycles using the step-up procedure as compared with 51.3% using the step-down procedure (P < 0.01). The cumulative rate of clinical gestations during the study did not differ between the two groups (38.6% in the step-up versus 30.8% in the step-down procedure). CONCLUSIONS: The step-up protocol using rFSH (Puregon ‚ ), is more efficient in obtaining a monofollicular development and ovulation than the step-down protocol, in women with CC-resistant polycystic ovaries. Although the duration of stimulation is longer, the rate of ovarian hyperstimulation is much lower using the step-up protocol.
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Citations
Polycystic ovary syndrome.
Ricardo Azziz,Enrico Carmina,Zi-Jiang Chen,Andrea Dunaif,Joop S.E. Laven,Richard S. Legro,Daria Lizneva,Daria Lizneva,Barbara Natterson-Horowtiz,Helena J. Teede,Bulent O. Yildiz +10 more
- 11 Aug 2016
TL;DR: PCOS can impact women’s reproductive health, leading to anovulatory infertility and higher rate of early pregnancy loss, and the risks of diabetes, cardiovascular disease, hypertension, metabolic syndrome, and endometrial cancer among PCOS patients are significantly increased.
Epidemiology, diagnosis, and management of polycystic ovary syndrome
Susan M Sirmans,Kristen A. Pate +1 more
TL;DR: Proper diagnosis and management of PCOS is essential to address patient concerns but also to prevent future metabolic, endocrine, psychiatric, and cardiovascular complications.
Consensus on infertility treatment related to polycystic ovary syndrome
Thessaloniki,Greece. +1 more
TL;DR: The treatment of infertile women with polycystic ovary syndrome (PCOS) is surrounded by many controversies, and a group of experts reached a consensus regarding the therapeutic challenges raised in these women.
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Polycystic Ovary Syndrome
Stephen Franks
- 01 Apr 2007
TL;DR: It is of interest to realize that polycystic ovary syndrome has moved from a histology diagnosis of ovarian tissue to a heterogeneous clinical syndrome, to a reproductive endocrine abnormality with elevated serum luteinizing hormone and androgen levels, and to a metabolic disease characterized by hyperinsulinemia and dyslipidemia.
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Treatment options for polycystic ovary syndrome.
Ahmed Badawy,Abubaker Elnashar +1 more
TL;DR: Alternative medicine has been emerging as one of the commonly practiced medicines for different health problems, including PCOS, which underlines the contribution to the treatment of different symptoms.
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WHO Manual for the Standardized Investigation and Diagnosis of the Infertile Male
P. J. Rowe,Frank Comhaire,Timothy B. Hargreave,H Mellows +3 more
- 01 Mar 2000
TL;DR: The manual for the standardized investigation and diagnosis of the infertile couple is one of the literary work in this world in suitable to be reading material and will show the amazing benefits of reading a book.
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Manipulation of Human Ovarian Function: Physiological Concepts and Clinical Consequences
TL;DR: The FSH threshold and window concept for in vivo follicle growth, and the concept of monofollicle growth in anovulatory patients, are described.
Multifollicular Ovaries: Clinical and Endocrine Features and Response to Pulsatile Gonadotropin-Releasing Hormone
Judith M. Adams,D. W. Polson,N. A. Abdulwahid,David V. Morris,Stephen Franks,H. D. Mason,M. Tucker,Jackie F. Price,Howard S. Jacobs +8 more
TL;DR: In this article, a multifollicular ovarian appearance was observed in women with weight-loss-related amenorrhoea, which may represent a normal ovarian response to weight-related hypothalamic disturbance of gonadotropin control.
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Prediction of the individual follicle-stimulating hormone threshold for gonadotropin induction of ovulation in normogonadotropic anovulatory infertility: an approach to increase safety and efficiency.
Babak Imani,Marinus J.C. Eijkemans,G. H. Faessen,Philippe Bouchard,Linda C. Giudice,Bart C.J.M. Fauser +5 more
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