Results of the use of a pure urinary FSH stimulation regime in patients unsuccessfully treated with hMG in an in vitro fertilization program.

63 infertile patients who failed in achieving pregnancy for several cycles with human menopausal gonadotropin stimulation protocol in our in vitro fertilization program were subsequently treated with urinary FSH regime. In 25 of these patients, the leading diagnosis was an elevated basal LH/FSH ratio (i.e. above 2), 29 women had an irreparable tubal factor, 9 patients had endometriosis, and 21 couples suffered from an additional male factor. The FSH stimulation protocol was initiated on day 2 of the cycle, the highest doses were given on the first days and reduced thereafter. Hormone measurements concerning estradiol and LH were started on day 2 of the cycle, ultrasonic evaluation on day 7 of the cycle. After 48 pelviscopic follicle punctures and 39 embryotransfers 12 cases resulted in clinical pregnancies. One case terminated in a miscarriage and 2 pregnancies were of ectopic location.