Use of Pulsatile Intravenous FSH to Mitigate Reprometabolic Syndrome

Inclusion Criteria (obseity): * • BMI between 30 kg/m2 and 40 kg/m * Weight stability, i.e. no continued weight loss of \>1lb per week for a minimum of 4 weeks prior to enrollment * Normal thyroid stimulating hormone (TSH) and prolactin * Anti-Mullerian Hormone (AMH) \> 1 ng/ml or \< 8 ng/mL * Willingness to postpone conception for the first study cycle * Involuntary inability to conceive for at least 6 months * No clinical diagnosis of polycystic ovarian syndrome (PCOS) * Documentation of ovulation with luteal progesterone \>6 ng/ml or positive ovulation predictor home testing * Regular menstrual cycles 25-40 days in length * Male partner (or sperm donor) with adequate sperm (\>14 million sperm per ml) * Hysterosalpingogram or saline infusion sonography demonstrating at least one patent Fallopian tube and a normal uterine cavity * Serum total and free testosterone within the 95% CIearance for women with obesity previously studied in our laboratory. * Acceptance of the indwelling catheter and willingness to take part in the study Inclusion criteria (DOR): * BMI less than 30 kg/m2 * Normal TSH and prolactin * Regular menstrual cycles 25-40 days in length * Male partner (or sperm donor) with adequate sperm (\>14M sperm per ml) * Hysterosalpingogram or saline infusion sonography demonstrating at least one patent Fallopian tube and a normal uterine cavity * Anti-Mullerian Hormone (AMH) \< 1.0 ng/ml * Antral follicle count 8 or less * Willingness to postpone conception for the first study cycle * at least 2 prior canceled cycles for lack of response at maximum dose * Involuntary inability to conceive for at least 6 months * Acceptance of the indwelling catheter and willingness to take part in the study