Ovulation induction
Effects of pretreatment with estrogens on ovarian stimulation with gonadotropins in women with premature ovarian failure: a randomized, placebo-controlled trial

https://doi.org/10.1016/j.fertnstert.2006.08.086Get rights and content
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Objective

To evaluate the hypothesis that pretreatment with estrogens in women affected by premature ovarian failure (POF) may improve the results of ovarian stimulation.

Design

Double-blind, randomized, placebo-controlled study.

Setting

Outpatient department in an academic research environment.

Patient(s)

Fifty women with POF seeking pregnancy.

Intervention(s)

Before starting ovarian stimulation, group 1 received 0.05 mg ethinyl-E2 (EE) three times a day for 2 weeks, while group 2 received placebo. Ovarian stimulation was carried out with recombinant FSH (r-βFSH), 200 IU/day/SC. Both EE and placebo were administered during ovarian stimulation. Human chorionic gonadotropin (10,000 IU/IM) was added when the follicle exceeded a mean diameter of 18 mm.

Main Outcome Measure

Rate of ovulation in women with POF.

Result(s)

Levels of FSH before stimulation were significantly lower in group 1 than in group 2. The rate of ovulation in group 1 (8/25; 32%) was significantly higher than in group 2 (0/25; 0%). Notably, induction of ovulation was successful only in patients whose FSH levels after EE treatment were ≤15 mIU/mL.

Conclusion(s)

Our data suggest that pretreatment with EE improves the success of rate of ovulation induction with exogenous gonadotropins in patients with POF. A threshold of FSH ≤15 mIU/mL should be achieved before starting ovarian stimulation.

Key Words

Estrogen therapy
gonadal failure
ovulation induction
premature ovarian failure

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