Step-up protocol for ovulation induction

Schematic representation of the low-dose, step-up protocol of gonadotropin administration for ovulation induction. The initial subcutaneous or intramuscular dose of FSH is 37.5 to 75 IU/day; the dose is increased only if, after 14 days, no response is documented on ultrasonography and serum estradiol monitoring. Increments of 37.5 IU then are given at weekly intervals up to a maximum of 225 IU/day. Detection of an ovarian response is an indication to continue the current dose until hCG can be given to stimulate ovulation.