Is corifollitropin alfa effective in controlled ovarian stimulation among all poor ovarian responders? A retrospective comparative study

Abstract

Several studies have compared the effectiveness of corifollitropin alfa versus daily gonadotropins in poor ovarian responders (PORs) undergoing controlled ovarian stimulation (COS), showing conflicting results in terms of IVF outcomes. Given the heterogeneity of patients included in the classification of POR according to ‘Bologna criteria’, the aim of this study was to evaluate the impact of corifollitropin alfa in two different categories of POR distinguished according to patients’ antral follicle count (AFC). We retrospectively evaluated 104 infertile POR, split into two groups according to AFC (Group A ≤ 5; Group B > 5) and subgroups according to the ovarian stimulation regimen (corifollitropin alfa plus daily gonadotropins (Subgroup 1) versus daily gonadotropins alone (Subgroup 2)). Outcome measures were total oocytes, MII oocytes, total embryos, follicular output rate (FORT), implantation rate (IR), clinical pregnancy rate (CPR), miscarriage rate (MR), and live birth rate (LBR). Subgroup A1 experienced a lower number of total oocytes, MII oocytes, total embryos, and FORT (p < .05) in comparison to Subgroup A2, while no difference was found when comparing Subgroups B1 and B2. No difference was found between subgroups even in terms of IR, CPR, MR, and LBR. In conclusion, corifollitropin alfa may be as effective as daily gonadotropins in POR with AFC > 5 undergoing COS, while it might be inferior to daily gonadotropins in POR with AFC ≤ 5.

摘要

一些研究比较了卵巢低反应患者应用绒促卵泡素α或每日促性腺激素进行控制性卵巢刺激的效果, 其IVF结局结果存在争议。根据“博洛尼亚标准”分类卵巢反应不良（POR）患者的具有异质性, 本研究是评估根据患者的窦状卵泡计数（AFC）分为两类的POR患者应用绒促卵泡素α的作用。本研究回顾性的评估了104例不孕的POR患者, 根据AFC分为两组（A组：≤5组；B组>5）, 根据卵巢刺激方案分为两组：绒促卵泡素α联合每日促性腺激素（亚组1）和每日单用促性腺激素（亚组2）。结果测量指标为获卵数、MII期卵母细胞、胚胎总数、卵泡输出率（FORT）、着床率（IR）、临床妊娠率（CPR）、流产率（MR）和活产率（LBR）。与A2组相比, A1组的获卵数、MII期卵母细胞、总胚胎和FORT数量较低（p<0.05）, 而B1和B2组间无明显差异。各亚组间在IR、CPR、MR、LBR方面无明显差异。综上所述, 对于AFC>5的POR患者应用绒促卵泡素α与每日使用的促性腺激素可能一样有效, 而AFC≤5的POR患者中, 应用绒促卵泡素α可能较每日应用促性腺激素效果稍差。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Corifollitropin alfa
• daily gonadotropins
• poor ovarian responders
• controlled ovarian stimulation
• Bologna criteria

Disclosure statement

No potential conflict of interest was reported by the authors.