Comparison between stimulation with highly purified hMG or recombinant FSH in patients undergoing IVF with GnRH antagonist protocol

Abstract

Purpose: Highly purified Human Menopausal Gonadotropins (hp-hMG) and recombinant FSH (rFSH) are widely used in assisted reproductive technology (ART). The aim of this study was to compare ART results of the two preparations in GnRH antagonist cycles.

Methods: In this retrospective cohort study, IVF antagonist cycles performed from 2011 through 2013 were reviewed. There were 508 antagonist cycles: 320 stimulated with rFSH and 188 with hp-hMG. For every hp-hMG, two rFSH were matched for patient's age and infertility diagnosis. Subgroup analysis of patients younger and older than 35 was done as well.

Results: Both treatments were resulted in comparable pregnancy and live birth rates. However, cumulative pregnancy rates were higher for the rFSH group. In the matching analysis, the rFSH group had more mature oocytes and more embryos while using lower doses of gonadotropins. Pregnancy, cumulative pregnancy rates, and live birth rates were comparable. In the subgroup analysis, young patients in the rFSH group had better cycle outcomes compared with those in the hp-hMG group.

Conclusion: In antagonist protocol, different gonadotropin products are equally effective. The choice of one or the other should depend on the availability, convenience of use, and cost.

Chinese abstract

目的: 高纯尿促性素(hp-hMG)与重组卵泡刺激素(rFSH)广泛应用于辅助生殖技术(ART)。本研究的目的为比较GnRH抑制周期中应用两者的ART结局。

方法: 在这项回顾性队列研究募集了2011年至2013年进行的体外受精拮抗剂周期。共508个拮抗剂周期: 其中320个为rFSH周期和188个hp-hMG周期。每个hp-hMG周期有两个年龄和不孕诊断相匹配的rFSH周期匹配。同时对年龄小于或者大于35岁的患者进行亚组分析。

结果: 两种方案治疗结局的妊娠和活产率均可比, 然而rFSH组的累积妊娠率更高。匹配分析表明, 当使用较低剂量的促性腺激素时, rFSH组的成熟卵母细胞和胚胎更多。妊娠, 累积妊娠率及活产率具有可比性。亚组分析表明rFSH组的年轻患者比hp-hMG组的年轻患者周期结局更好。

结论: 在拮抗剂周期中使用不同的促性腺激素产品效果相当。应根据可用性、使用的便利和花费进行选择。

• Antagonist protocol
• assisted reproductive technology
• infertility
• ovulation induction

Acknowledgements

The authors thank Ronit Leiba for performing the statistical analyses.

Declaration of interest

The authors report no declarations of interest.