Yildizhan R, Adali E, Kolusari A, Kurdoglu M, Yildizhan B, Sahin H G, Kamaci M
Department of Obstetrics and Gynaecology, Medical Faculty, Yuzuncu Yil University, Van, Turkey.
J Int Med Res. 2008 Nov-Dec;36(6):1197-204. doi: 10.1177/147323000803600605.
Sixty-seven infertile women with polycystic ovary syndrome (PCOS) were divided into two groups, obese and non-obese, according to their body mass index. Waist-to-hip ratio, insulin resistance, total testosterone and dehydroepiandrosterone sulphate levels were significantly elevated in obese, compared with non-obese, patients. Both groups were treated with a low-dose step-up protocol of recombinant follicle-stimulating hormone (rFSH) with a starting dose of 50 IU/day and, every third day, a 25-IU increase in the dose until the appropriate dose was achieved for each individual, up to a maximum of 175 IU/day. In the obese group only, repeat therapy commenced in the second ovulatory cycle in women who had not become pregnant, however a starting dose of 75 IU/day was then used, with incremental and maximum dose as before. The results of the starting dose of 75 IU/day rFSH were compared with the results of a 50 IU/day rFSH starting dose in the obese group. A starting dose of 50 IU/day rFSH in a low-dose step-up regimen was found to be effective, safe and well-tolerated for inducing follicular development in non-obese infertile women with PCOS. However, for obese PCOS patients, a starting dose of 75 IU/day rFSH is recommended.
67名患有多囊卵巢综合征（PCOS）的不孕女性根据体重指数被分为肥胖组和非肥胖组。与非肥胖患者相比，肥胖患者的腰臀比、胰岛素抵抗、总睾酮和硫酸脱氢表雄酮水平显著升高。两组均采用低剂量递增方案的重组促卵泡激素（rFSH）进行治疗，起始剂量为50IU/天，每三天剂量增加25IU，直至达到每个个体的合适剂量，最大剂量为175IU/天。仅在肥胖组中，未怀孕的女性在第二个排卵周期开始重复治疗，然而此时起始剂量为75IU/天，增量和最大剂量与之前相同。将肥胖组中75IU/天rFSH起始剂量的结果与50IU/天rFSH起始剂量的结果进行比较。发现低剂量递增方案中50IU/天rFSH的起始剂量对于诱导非肥胖PCOS不孕女性的卵泡发育是有效、安全且耐受性良好的。然而，对于肥胖的PCOS患者，建议起始剂量为75IU/天rFSH。
