A randomized prospective cross-over study of highly purified follicle-stimulating hormone and human menopausal gonadotrophin for ovarian hyperstimulation in women aged 37-41 years.

PURPOSE: In the present study, we investigated the benefits of highly purified FSH (H.P. FSH) in comparison with human menopausal gonadotrophin (hMG) in IVF patients aged 37-41 years. METHODS: Twenty patients experienced within a period of four months both preparations in subsequent cycles through a prospective randomized cross-over design. A standard hormonal treatment consisting of a flare-up protocol using gonadotrophin-releasing hormone agonist (GnRHa) in combination with the same starting dose of H.P. FSH or hMG was used in all cycles. RESULTS: Cycles stimulated with H.P. FSH resulted in a significantly higher mean number (10.3 +/- 3) of ovocytes retrieved with a significantly shorter (13 +/- 2.3 days) duration of stimulation compared to cycles treated with hMG [mean number of oocytes 7.3 +/- 5 (P < 0.01) and mean duration of stimulation 14.7 +/- 3.9 days (P < 0.02)]. No detrimental effect of basal or exogenous LH on oocyte quality was observed in our study. CONCLUSIONS: In our experience, H.P. FSH preparations seemed to be more effective than hMG preparations for ovarian stimulation in this group of women aged 37-41 years.