BACKGROUND: The aim of the study was to evaluate follicular development and ovulation comparing the low-dose step-up and the step-down protocols, in @entity1 with @entity4082 (CC)-resistant @entity3610 . METHODS: Eighty-three @entity1 were randomized, and treated with recombinant (r) FSH (Puregon) using either the step-up (n=44) or step-down (n=39) protocol. They were followed up for three cycles unless pregnancy occurred. RESULTS: Monofollicular development occurred in 68.2% of the 85 cycles in the step-up group, as compared with 32% of the 72 cycles in the step-down group (P<0.0001). @entity14563 was statistically less frequent using the step-up procedure (4.7 versus 36%, P<0.0001). Both protocols used the same number of FSH units per cycle (951+/-586 versus 967+/-458 in step-up and step-down respectively, P=not significant). However, the duration of ovarian stimulation was statistically different (15.2+/-7.0 days in step-up versus 9.7+/-3.1 in step-down, P<0.001). Ovulation was observed in 70.3% of the cycles using the step-up procedure as compared with 51.3% using the step-down procedure (P<0.01). The cumulative rate of clinical gestations during the study did not differ between the two groups (38.6% in the step-up versus 30.8% in the step-down procedure). CONCLUSIONS: The step-up protocol using rFSH (Puregon), is more efficient in obtaining a monofollicular development and ovulation than the step-down protocol, in @entity1 with @entity3610 . Although the duration of stimulation is longer, the rate of @entity43 is much lower using the step-up protocol.

A comparative randomized multicentric study comparing the step-up versus step-down protocol in XXXX .

@entity1 :: ('9606', 'Species') :: ['women'] @entity43 :: ('MESH:D010051', 'Disease') :: ['ovarian hyperstimulation'] @entity3610 :: ('MESH:D011085', 'Disease') :: ['CC-resistant polycystic ovaries', 'polycystic ovaries'] @entity14563 :: ('MESH:D016471', 'Disease') :: ['Hyperstimulation'] @entity4082 :: ('MESH:D002996', 'Chemical') :: ['clomiphene citrate']
@entity3610 :: (MESH:D011085,Disease) :: ['polycystic ovary syndrome']
