OBJECTIVE: To compare the effectiveness of highly purified hMG with recombinant FSH (rFSH) in IVF-intracytoplasmic sperm injection patients who were treated with a GnRH agonist. DESIGN: An open-label, prospective, randomized comparison of fixed gonadotropin regimens. SETTING:Eighteen Dutch IVF centers. PATIENT(S): Six hundred twenty-nine patients who were selected for IVF-intracytoplasmic sperm injection. INTERVENTION(S): Patients were randomized to receive either highly purified hMG or rFSH in a fixed dosage of 150 IU/d after GnRH-agonist suppression (long protocol). MAIN OUTCOME MEASURE(S): Ongoing pregnancy rate per started cycle. Difference between the two treatment groups was tested by using odds ratios, including the 95% confidence limits (intention-to-treat sample), and by using the Fisher's exact test (per-protocol sample). RESULT(S): The ongoing pregnancy rates per started cycle were 26.3% and 25.2% for highly purified hMG and rFSH, respectively (no statistically significant difference). Treatment with highly purified hMG resulted in statistically significantly fewer oocytes (n = 7.8) than did treatment with rFSH (n = 10.6). There were no differences with respect to fertilization rates and implantation rates. Cycles with highly purified hMG were statistically significantly less often canceled as a result of ovarian hyperresponse (2.0% vs. 6.0% for highly purified hMG and rFSH, respectively). CONCLUSION(S): Compared with rFSH, highly purified hMG did not result in superiority in ongoing pregnancy rates in first-cycle IVF-intracytoplasmic sperm injection patients who were treated with a fixed dosage of 150 IU of gonadotropin per day. Compared with rFSH, treatment with highly purified hMG resulted in retrieval of fewer oocytes, a lower incidence of hyperresponse, and comparable pregnancy rates.
RCT Entities:
OBJECTIVE: To compare the effectiveness of highly purified hMG with recombinant FSH (rFSH) in IVF-intracytoplasmic sperm injection patients who were treated with a GnRH agonist. DESIGN: An open-label, prospective, randomized comparison of fixed gonadotropin regimens. SETTING: Eighteen Dutch IVF centers. PATIENT(S): Six hundred twenty-nine patients who were selected for IVF-intracytoplasmic sperm injection. INTERVENTION(S): Patients were randomized to receive either highly purified hMG or rFSH in a fixed dosage of 150 IU/d after GnRH-agonist suppression (long protocol). MAIN OUTCOME MEASURE(S): Ongoing pregnancy rate per started cycle. Difference between the two treatment groups was tested by using odds ratios, including the 95% confidence limits (intention-to-treat sample), and by using the Fisher's exact test (per-protocol sample). RESULT(S): The ongoing pregnancy rates per started cycle were 26.3% and 25.2% for highly purified hMG and rFSH, respectively (no statistically significant difference). Treatment with highly purified hMG resulted in statistically significantly fewer oocytes (n = 7.8) than did treatment with rFSH (n = 10.6). There were no differences with respect to fertilization rates and implantation rates. Cycles with highly purified hMG were statistically significantly less often canceled as a result of ovarian hyperresponse (2.0% vs. 6.0% for highly purified hMG and rFSH, respectively). CONCLUSION(S): Compared with rFSH, highly purified hMG did not result in superiority in ongoing pregnancy rates in first-cycle IVF-intracytoplasmic sperm injection patients who were treated with a fixed dosage of 150 IU of gonadotropin per day. Compared with rFSH, treatment with highly purified hMG resulted in retrieval of fewer oocytes, a lower incidence of hyperresponse, and comparable pregnancy rates.
Authors: Jared C Robins; Andrew F Khair; Eric A Widra; Michael M Alper; Winnie W Nelson; Eric D Foster; Anshul Sinha; Masakazu Ando; Patrick W Heiser; Gaurang S Daftary Journal: F S Rep Date: 2020-11-10
Authors: P E Levi Setti; C Alviggi; G L Colombo; C Pisanelli; C Ripellino; S Longobardi; P L Canonico; G De Placido Journal: J Endocrinol Invest Date: 2014-12-06 Impact factor: 4.256