Corifollitropin alfa compared with follitropin beta in GnRH-antagonist ovarian stimulation protocols in an unselected population undergoing IVF/ICSI

Abstract

Recombinant DNA technologies have produced Corifollitropin alfa (CFa) used during IVF/ICSI in order to keep the circulating FSH levels above the threshold necessary to support multi-follicular growth for a week. In this prospective case-control study, we compared 70 participants treated with 150 μg CFa combined with 150 IU of follitropin beta (study group) with 70 subfertile participants with matching baseline characteristics, conforming with the same inclusion criteria and treated with an antagonist protocol using follitropin beta (control group). Live birth was the primary outcome, while secondary outcome measures were IVF/ICSI cycles characteristics, including adverse events and complications. Live birth was determined in reduced rates in the study compared to the control group, reaching statistical significance [6/70 versus 20/70, p = 0.002], as also in the respective number of clinical pregnancies [9/70 versus 23/70, p = 0.005], although the incidence of miscarriage was similar for both groups [6/70 versus 5/70, p > 0.99]. Most of the secondary parameters examined were similar between groups. Logistic regression revealed that protocol and AFC had a direct impact on live birth. Ovarian stimulation with CFa does not seem to constitute an equally effective method as compared with follitropin beta to be offered in a general subfertile population seeking IVF/ICSI treatments.

Chinese abstract

利用重组DNA技术已经生产了绒促卵泡素α用于IVF/ICSI, 以便使循环FSH水平保持在维持多个卵泡生长1周所需的阈值以上。在这项前瞻性病例对照研究中, 我们将70名用150mg绒促卵泡素α联合150IU促卵泡素β的受试者（研究组）与70名符合相同的入选标准的基线特征匹配的低生育力受试者进行对照, 并按照拮抗剂方案用促卵泡素β（对照组）。研究的主要结局为活产, 次要结局指标为IVF/ICSI 周期特征, 包括不良事件和并发症。按照降低的活产比率组间进行比较, 二组差异具有统计学意义[6/70 与 20/70, p = 0.002], 临床妊娠率差异同样具有统计学意义[9/70 与 23/70,p = 0.005], 尽管两组具有相似的流产率[6/70 与 5/70, p > 0.99]。两组大多数次要参数是相似的。Logistic回归显示对于IVF/ICSI治疗生育能力低下的人群, 促排方案与AFC对活产率具有直接的影响。与用促卵泡素β相比, 用绒促卵泡素α的卵巢刺激方案似乎并不是等效治疗方案。

Keywords:

• Assisted reproductive techniques
• corifollitropin alfa
• GnRH antagonist
• pregnancy
• normal responders

Acknowledgements

The authors wish to thank the clinical, paramedical and laboratory team of the Assisted Reproduction Units of all three centers, and especially Dr Basios George, Dr Salamalekis George, the embryologist Tereza Vrantza, and the student Marianna Belmpa for the collection of data of the Attikon Hospital, as well as Sotiria Pappa for the collection of data of the IVF Unit of the University Hospital of Larisa. There was no funding for the current work.

Declaration of interest

All authors declare no conflict of interest.