Could the addition of hp-hMG and GnRH antagonists modulate the response in IVF-ICSI cycles?

Abstract

Objective. To assess if the luteinizing hormone / human chorionic gonadotropin present in some gonadotropin formulations may be of benefit in protocols with GnRH antagonists.

Methods. Open, quasi-experimental, multicenter, prospective, parallel-controlled study compared 136 women undergoing in vitro fertilization – intracytoplasmic sperm injection after stimulation with highly purified human menopausal gonadotropin (hp-hMG) (n = 44), recombinant-follicle stimulating hormone (r-FSH) (n = 46), or a combination of both (r FSH + hp-hMG) (n = 46) following an antagonist protocol. Blood determinations were made on day 6 of stimulation and on the day of ovulation induction, with centralized analysis.

Results. No differences were found in the ongoing pregnancy rates between groups [37.0% versus 29.5% (hp-hMG) and 23.9% (r-FSH); p = 0.688]. However, the ratio top-quality embryos / retrieved oocytes (TQE/RO) was higher in the combined therapy group (19.6%) – reaching significance versus the r-FSH group (6.5%) (p = 0.008), but not versus hp-hMG (12.3%) (p = 0.137).

Conclusions. An improved TQE/RO ratio was obtained together with a greater percentage of frozen embryos in the patients that incorporated hp-hMG to their stimulation protocol. Despite good results of adding hp-hMG, non statistical differences were found in terms of ongoing pregnancy rate.

Keywords:

• Embryo quality
• GnRH antagonist
• highly purified menotrophin
• ovulation induction
• recombinant-FSH

Acknowledgments

This study was supported by IVI Madrid, Madrid, Spain. The authors report no other conflict of interest. The authors alone are responsible for the content and writing of the article.