Fertility and assisted reproduction

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A randomised controlled trial of 300 versus 225 IU recombinant FSH for ovarian stimulation in predicted normal responders by antral follicle count

  1. K Jayaprakasan,
  2. J Hopkisson,
  3. B Campbell,
  4. I Johnson,
  5. J Thornton,
  6. N Raine-Fenning

Article first published online: 29 MAR 2010

DOI: 10.1111/j.1471-0528.2010.02545.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 117, Issue 7, pages 853–862, June 2010

Additional Information

How to Cite

Jayaprakasan, K., Hopkisson, J., Campbell, B., Johnson, I., Thornton, J. and Raine-Fenning, N. (2010), A randomised controlled trial of 300 versus 225 IU recombinant FSH for ovarian stimulation in predicted normal responders by antral follicle count. BJOG: An International Journal of Obstetrics & Gynaecology, 117: 853–862. doi: 10.1111/j.1471-0528.2010.02545.x

Author Information

  1. Nottingham University Research and Treatment Unit in Reproduction (NURTURE), Division of Human Development, School of Clinical Sciences, University of Nottingham, Nottingham, UK

*Dr K Jayaprakasan, NURTURE, B Floor, East Block, Queen’s Medical Centre, Nottingham, Nottinghamshire NG7 2UH, UK. Email k.jayaprakasan@nottingham.ac.uk

Publication History

  1. Issue published online: 10 MAY 2010
  2. Article first published online: 29 MAR 2010
  3. Accepted 10 February 2010. Published Online 29 March 2010.

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Keywords:

  • Antral follicle count;
  • IVF/ICSI outcome;
  • ovarian response;
  • predicted normal responders;
  • randomised controlled trial;
  • recombinant gonadotrophin

Please cite this paper as: Jayaprakasan K, Hopkisson J, Campbell B, Johnson I, Thornton J, Raine-Fenning N. A randomised controlled trial of 300 versus 225 IU recombinant FSH for ovarian stimulation in predicted normal responders by antral follicle count. BJOG 2010;117:853–862.

Objective  To test the hypothesis that among women predicted to have a normal ovarian response, ovarian stimulation using 300 IU follicle-stimulating hormone (FSH) results in the retrieval of more mature oocytes than 225 IU during in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) treatment.

Design  Prospective randomised controlled study.

Setting  University-based assisted conception unit.

Population  A cohort of 131 women predicted to have a normal ovarian response to gonadotrophin stimulation, based on antral follicle count.

Methods  Subjects undergoing their first cycle of IVF/ICSI were randomised to receive a fixed daily dose of 300 (experimental arm) or 225 IU (control arm) of recombinant FSH (Gonal-F).

Main outcome measures  Number of mature oocytes retrieved and live birth rates.

Results  The number (mean ± standard deviation) of mature oocytes retrieved (8.2 ± 5.0 versus 9.0 ± 4.8, for 300 and 225 IU, respectively; P = 0.34) was similar in each group. There were no differences between the 300- and 225 IU arms in live birth rates (31 versus 41%, respectively; P = 0.25), cycle cancellations resulting from insufficient ovarian response (0 versus 6.1%, respectively; P = 0.12), and prevalence of moderate (3.1 versus 3.0, respectively; P = 1.0) and severe (0 versus 1.5%, respectively; P = 1.0) ovarian hyperstimulation syndrome.

Conclusions  The use of a higher daily dose of 300 IU of recombinant FSH for ovarian stimulation does not improve the number of mature oocytes retrieved, or live birth rates, among women with a predicted normal response during conventional IVF/ICSI.

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