Analysis of variables in treatment of anovulation with human gonadotrophins

Twenty seven women with anovulation were given 121 courses of gonadotrophins monitored by excretion of estrogen and pregnanediol. The FSH, ovulating dosage of HCG, time interval between FSH and HCG and subsequent supporting doses of HCG were varied in a statistical design. None significantly affected ovulation or pregnancy rates. The preparation with an FSH:LH ratio of 1 required a lower dosage to initiate an estrogen response than that with a ratio of 5. After adjustment it still produced a faster rise in estrogen excretion. The amount of estrogen also varied with the time interval between FSH and HCG, the ovulating dose of HCG and supporting doses of HCG. The amount of pregnanediol varied with the ovulating dose of HCG and the length of the luteal phase varied with the ovulating dose of HCG and supporting injections of HCG. The dosage of FSH needed to initiate a response increased on average by 8% from one course to the next. Simplicity, economy and risk of multiple pregnancy are discussed in relation to these variables.