Low Dose Gonadotropin Protocol for Ovulation Induction in Low Resource Centre

The use of gonadotropins has been advocated for anovulation infertility especially in clomiphene resistant situation. But their use has been limited by the side effects particularly hyper stimulation syndrome as well as high cost/unavailability of the drugs and means of monitoring in the low resource area. The low dose protocol in this prospective study consists of 75IU of human menopausal gonadotropin on day 3, 5 and 7. Seventy three per cent of the patients developed matured Graffian follicle, unifollicle in 56.7% and 70% of them were able to get pregnant over 3 cycles with cumulative pregnancy rate of 32.8% of all the stimulated cycles. This result is favourably compared to outcome in other protocols. There was no incidence of ovarian hyper stimulation syndrome while 3.1% of the patients had twins. Age and duration of infertility appeared to influence the response to gonadotropins (P < 0.05) while body mass index and presence of polycystic ovarian disease did not. This low dose protocol will benefit patients in low resource area considering the lower drugs usage with favourable effectiveness, no complication and thereby require little monitoring.