Objective: To determine whether a starting dose of 50 units of recombinant FSH (follitropin beta, Puregon; Organon Laboratories Limited, Cambridge, United Kingdom) produces a follicular response in patients with clomiphene citrate-resistant polycystic ovary syndrome (PCOS).
Design: Prospective observational study.
Setting: Routine clinical practice in a teaching hospital fertility unit.
Patient(s): Patients with clomiphene citrate-resistant PCOS who wanted to become pregnant.
Intervention(s): Low-dose step-up protocol of SC recombinant FSH administration, monitored prospectively by transvaginal ultrasonography and retrospectively by serum endocrine assays taken at each monitoring visit.
Main outcome measure(s): Rate and size of follicular growth, recombinant FSH requirement, E2 response, ovulation, cycle cancellation, and pregnancy.
Result(s): All patients exhibited a follicular response: Six patients ovulated, of whom two conceived and four had their cycles cancelled because of overstimulation. One patient did not ovulate despite the development of a follicle.
Conclusion(s): Recombinant FSH can be used successfully to stimulate follicular growth at a starting dose of 50 IU.