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Highly purified HMG versus recombinant FSH for ovarian stimulation in IVF cycles

Reproductive BioMedicine Online, 2, 17, pages 190 - 198

Abstract

The objective of this study was to compare the live birth rates resulting from ovarian stimulation with highly purified human menopausal gonadotrophin (HP-HMG), which combines FSH and human chorionic gonadotrophin-driven LH activities, or recombinant FSH (rFSH) alone in women undergoing IVF cycles. An integrated analysis was performed of the raw data from two randomized controlled trials that were highly comparable in terms of eligibility criteria and post-randomization treatment regimens with either HP-HMG or rFSH for ovarian stimulation in IVF, following a long down-regulation protocol. All randomized subjects who received at least one dose of gonadotrophin in an IVF cycle (HP-HMG,n= 491; rFSH,n= 495) were included in the analysis. Subjects who underwent intracytoplasmic sperm injection cycles were excluded. The superiority of one gonadotrophin preparation over the other was tested using the likelihood ratio test in a logistic regression analysis. The live birth rate per cycle initiated was 26.5% (130/491) with HP-HMG and 20.8% (103/495) with rFSH (P= 0.041). The odds ratio in favour of HP-HMG was 1.36 (95% confidence interval: 1.01–1.83). Thus, the findings of this integrated analysis demonstrate that ovarian stimulation with HP-HMG, following a long down-regulation protocol, in IVF cycles results in significantly more live births than stimulation with rFSH alone.

Keywords: highly purified HMG, IVF, LH activity, pregnancy outcome, randomized controlled trial, recombinant FSH.

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Dr Platteau is a Consultant in Reproductive Medicine at the University Hospital, Vrije Universiteit Brussel, Belgium. He graduated from Medical School at the University of Antwerp, Belgium, and is a member of the Royal College of Obstetricians and Gynaecologists, having qualified as a specialist in Obstetrics and Gynaecology at the University of Newcastle-upon-Tyne, United Kingdom. He also holds a Specialty Diploma in Tropical Medicine. His research work has focused in particular on the role of preimplantation genetic diagnosis for aneuploidy screening in infertility treatment. He has published in several medical books and journals and presented at international congresses.

Footnotes

a Centre for Reproductive Medicine of the Academisch Ziekenhuis Vrije Universiteit Brussel, Brussels, Belgium

b Rigshospitalet, Fertility Clinic, Copenhagen, Denmark

c Ferring Pharmaceuticals, St Prex, Switzerland

* Correspondence: Tel.: +32 496 122327; Fax: +32 2 3050357

The results of this study were presented in abstract form at the 22nd Annual Meeting of the European Society for Human Reproduction and Embryology, Prague, 18–21 June 2006.