Imperial College London
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Emeritus ProfessorStephenFranks

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Emeritus Professor of Reproductive Endocrinology
 
 
 
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Contact

 

+44 (0)20 7594 2109s.franks Website

 
 
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Assistant

 

Miss Kiran Dosanjh +44 (0)20 7594 4217

 
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Location

 

5009Institute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{White:2018:10.1530/REP-17-0697,
author = {White, D and Hardy, K and Lovelock, S and Franks, S},
doi = {10.1530/REP-17-0697},
journal = {Reproduction},
pages = {F1--F10},
title = {Low-dose gonadotropin induction of ovulation in anovulatory women - still needed in the age of IVF},
url = {http://dx.doi.org/10.1530/REP-17-0697},
volume = {156},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Low-dose, step-up gonadotropin is the treatment of choice for women with PCOS who have not conceived after anti-estrogen treatment, and as an effective alternative to pulsatile GnRH in women with hypogonadotropic hypogonadism (HH). There has been, however, no large-scale, comparative study between the two groups using low-dose gonadotropins. Here we performed a retrospective, comparative analysis, in a single clinic database, of efficacy and safety of induction of ovulation using low-dose gonadotropins in 364 Women with PCOS and 80 women with HH. The rate of ovulation was high in both PCOS (83%) and HH (84%) but mono-follicular, ovulatory cycles were more prevalent in PCOS than in HH (77% vs 53%, p<0.0001) and the proportion of cycles that were abandoned was higher in HH than in PCOS (25% vs 15%, p<0.0001). The median threshold dose of gonadotropin required to induce ovulation was 75iu/day in PCOS and 113iu/day in HH (p<0.001) and the range of doses was greater in HH women. Forty-nine percent of women with PCOS and 65% of those with HH conceived (more than 90% within 6 cycles of treatment) and had a least one pregnancy. Multiple pregnancies (all twins) occurred in only 4% of women with PCOS and 5% of those with HH. These findings emphasise the efficacy and safety of low-dose gonadotropin treatment for both clomiphene-resistant women with PCOS and those with HH. These results highlight the importance of choosing the more physiological approach of gonadotropin induction of ovulation in both groups as the most appropriate treatment, in preference to IVF.
AU  - White,D
AU  - Hardy,K
AU  - Lovelock,S
AU  - Franks,S
DO  - 10.1530/REP-17-0697
EP  - 10
PY  - 2018///
SN  - 1470-1626
SP  - 1
TI  - Low-dose gonadotropin induction of ovulation in anovulatory women - still needed in the age of IVF
T2  - Reproduction
UR  - http://dx.doi.org/10.1530/REP-17-0697
UR  - https://www.ncbi.nlm.nih.gov/pubmed/29459401
UR  - http://hdl.handle.net/10044/1/57700
VL  - 156
ER  -
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