{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:13:44Z","timestamp":1787022824619,"version":"build-2736575974"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2018,7,1]],"date-time":"2018-07-01T00:00:00Z","timestamp":1530403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["rep.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Low-dose, step-up gonadotropin is the treatment of choice for women with polycystic ovary syndrome (PCOS) who have not conceived after anti-oestrogen treatment and as an effective alternative to pulsatile GnRH in women with hypogonadotropic hypogonadism (HH). There has been, however, no large-scale, comparative study between the two groups using low-dose gonadotropins. Here, we performed a retrospective, comparative analysis, in a single clinic database, of efficacy and safety of induction of ovulation using low-dose gonadotropins in 364 women with PCOS and 80 women with HH. The rate of ovulation was high in both PCOS (83%) and HH (84%) but mono-follicular, ovulatory cycles were more prevalent in PCOS than in HH (77% vs 53%, P\u2009&amp;lt;\u20090.0001) and the proportion of cycles that were abandoned was higher in HH than in PCOS (25% vs 15%, P\u2009&amp;lt;\u20090.0001). The median threshold dose of gonadotropin required to induce ovulation was 75\u2009IU\/day in PCOS and 113\u2009IU\/day in HH (P\u2009&amp;lt;\u20090.001) and the range of doses was greater in HH women. Forty-nine percent of women with PCOS and 65% of those with HH conceived (more than 90% within 6 cycles of treatment) and had at least one pregnancy. Multiple pregnancies (all twins) occurred in only 4% of women with PCOS and 5% of those with HH. These findings emphasise the efficacy and safety of low-dose gonadotropin treatment for both clomiphene-resistant women with PCOS and those with HH. These results highlight the importance of choosing the more physiological approach of gonadotropin induction of ovulation in both groups as the most appropriate treatment, in preference to IVF.<\/jats:p>","DOI":"10.1530\/rep-17-0697","type":"journal-article","created":{"date-parts":[[2018,2,19]],"date-time":"2018-02-19T20:35:11Z","timestamp":1519072511000},"page":"F1-F10","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":26,"title":["Low-dose gonadotropin induction of ovulation in anovulatory women: still needed in the age of IVF"],"prefix":"10.1093","volume":"156","author":[{"given":"Davinia M","family":"White","sequence":"first","affiliation":[{"name":"Reproductive Medicine Clinic , Imperial College Healthcare NHS Trust, St Mary\u2019s Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Hardy","sequence":"additional","affiliation":[{"name":"Institute of Reproductive & Developmental Biology , Imperial College London, Hammersmith Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzannah","family":"Lovelock","sequence":"additional","affiliation":[{"name":"Institute of Reproductive & Developmental Biology , Imperial College London, Hammersmith Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Franks","sequence":"additional","affiliation":[{"name":"Institute of Reproductive & Developmental Biology , Imperial College London, Hammersmith Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,7,1]]},"reference":[{"key":"2026010712182637600_bib2","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1093\/oxfordjournals.humrep.a138750","article-title":"Cumulative conception and live birth rates after the treatment of anovulatory infertility: safety and efficacy of ovulation induction in 200 patients","volume":"9","author":"Balen","year":"1994","journal-title":"Human Reproduction"},{"key":"2026010712182637600_bib3","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1093\/humupd\/dmw025","article-title":"The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance","volume":"22","author":"Balen","year":"2016","journal-title":"Human Reproduction Update"},{"key":"2026010712182637600_bib4","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1677\/joe.0.0380451","article-title":"Preparation of gonadotrophin and growth hormone from human pituitaries for clinical use","volume":"38","author":"Brown","year":"1967","journal-title":"Journal of Endocrinology"},{"key":"2026010712182637600_bib5","doi-asserted-by":"publisher","first-page":"2294","DOI":"10.1093\/humrep\/deg446","article-title":"Bioavailability of hCG after intramuscular or subcutaneous injection in obese and non-obese women","volume":"18","author":"Chan","year":"2003","journal-title":"Human Reproduction"},{"key":"2026010712182637600_bib6","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1093\/oxfordjournals.bmb.a070736","article-title":"Induction of ovulation with gonadotrophins","volume":"26","author":"Crooke","year":"1970","journal-title":"British Medical Bulletin"},{"key":"2026010712182637600_bib8","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1111\/j.1471-0528.1963.tb04957.x","article-title":"Clinical trial of human gonadotrophins. 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