[Hormone profile and follicle development in ovarian stimulation treatment for in vitro fertilization. 1. FSH and LH profiles]

Abstract

144 patients were treated by 5 different stimulation protocols in the IVF-program of the University Women's Hospital Rostock (Clomiphene/HCG, Clomiphene/Anthrogon/HCG, Pergonal/HCG, Anthrogon/HCG, Folistiman/HCG). In 172 cycles FSH and LH were measured in serum during the follicular phase by RIA. The results were compared between the treatment groups and a group of normal women by Student's t-test or Mann-Whitney's nonparametric test. Moreover, in each group the number of follicles visible by laparoscopy and number of punctured follicles were estimated. The maturation of collected oocytes were judged by a maturation index. Modus of action and FSH/LH-ratio of used drugs have been shown to influence serum levels of FSH. Every stimulation protocol was characterized by typical profiles of hormones. Especially, immunoreactive levels of FSH were related to development of follicles. Different biological action of various stimulation regimes was demonstrated by a shortage of follicular phase from 13,4 days in the Clomiphene group to 11,0 days in the Folistiman group, an increase of laparoscopically visible follicles from 4,0 to 13,2 and a rise of collected oocytes from 1,6 to 7,3 per laparoscopy. Quality of oocytes has been shown to be related significantly to the modus of stimulation. Anthrogon-protocol was the most effective stimulation regime according to profile of gonadotropins, the number of follicles and the structure of harvested population of oocytes. However, even in this group co-dominant development of follicle was not achieved. Application of pure FSH and an earlier start of stimulation treatment are possibilities for improvements of results in IVF by stimulation.