Comparison of controlled ovarian stimulation with human menopausal gonadotropin or recombinant follicle-stimulating hormone.
OBJECTIVE
To carefully examine the features of controlled ovarian stimulation performed with recombinant FSH-alpha or hMG.


METHODS
Controlled, prospective, randomized comparison of fixed gonadotropin regimens.


METHODS
Academic research institution.


METHODS
Fifty infertile patients who were candidates for IUI.


METHODS
Patients were randomized to receive a fixed regimen of recombinant FSH-alpha (150 IU/day, 25 patients) or hMG (150 IU/day, 25 patients), after GnRH-agonist suppression (long regimen).


METHODS
Daily measurements of serum LH, immunoreactive FSH, hCG, E(2), P, and T. Transvaginal pelvic ultrasound every 2 days. Pregnancy and abortion rates. Cost of medications. Two recombinant FSH-alpha-treated patients did not respond. Despite matched daily FSH dose, duration of treatment (hMG 10.8 +/- 0.4 vs. recombinant FSH-alpha 12.4 +/- 0.5 days), gonadotropin dose (21.7 +/- 0.8 vs. 25.3 +/- 1.3 ampoules), gonadotropin cost (288 +/- 10 vs. 1,299 +/- 66 /cycle), serum P levels, and small preovulatory follicle number were significantly lower, and LH, hCG, immunoreactive FSH levels, and larger follicles on day 8 were significantly higher in hMG-treated patients. The pregnancy, abortion, and twin pregnancy rates did not differ.


CONCLUSIONS
The hMG administration was associated with: [1]. increased serum LH activity and immunoreactive FSH levels during treatment; [2]. reduced signs of premature luteinization; [3]. differential modulation of folliculogenesis; [4]. lower treatment duration, gonadotropin dose, and cost; and [5]. clinical outcome comparable to recombinant FSH-alpha.
Filicori
Marco
M
Reproductive Endocrinology Center, University of Bologna, Bologna, Italy. marco.filicori@unibo.it
Cognigni
Graciela E
GE
Pocognoli
Patrizia
P
Tabarelli
Cristina
C
Ferlini
Federica
F
Perri
Tiziana
T
Parmegiani
Lodovico
L
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D003338:Corpus Luteum / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016527:Drug Costs; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D015292:Glycoprotein Hormones, alpha Subunit / Q000008:administration & dosage / Q000097:blood / Q000191:economics / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000097:blood; D008596:Menotropins / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D006080:Ovarian Follicle / Q000503:physiopathology; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use
D005300:Fertility Agents, Female; D015292:Glycoprotein Hormones, alpha Subunit; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D007986:Luteinizing Hormone