Hmg preparations containing equal proportions of fsh and lh,
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Gonadotropin preparations have been used for ovarian stimulation since the early days of IVF and were originally developed in the United States.198 The daily administration of these preparations is usually efficacious in the induction and maintenance of growth of multiple dominant follicles, allowing for the retrieval of many oocytes for IVF. Preparations initially used were hMG (containing both LH and FSH bioactivity), followed by purified uFSH and more recently recFSH. No general consensus exists with regard to starting day and doses of gonadotropins. An overview of published randomized studies is given in Table 28-3. In conclusion, based on seven randomized controlled trials (RCTs) involving a total of 2563 cycles, although higher gonadotropin doses may result in the retrieval of 1 or 2 more oocytes, improved clinical outcomes in terms of pregnancy rates could not be demonstrated.