Effectiveness of human menopausal gonadotropin versus recombinant follicle-stimulating hormone for controlled ovarian hyperstimulation in assisted reproductive cycles: a meta-analysis.
OBJECTIVE
To compare the effectiveness of hMG and recombinant FSH after down-regulation for ovulation stimulation in assisted reproductive cycles.


METHODS
Meta-analysis.


METHODS
Infertility centers providing assisted reproductive techniques.


METHODS
Two thousand thirty women undergoing IVF or ICSI.


METHODS
Ovarian hyperstimulation with hMG or recombinant FSH after down-regulation.


METHODS
Clinical pregnancy rate, ongoing pregnancy/live birth rate, gonadotropin dose used, oocytes retrieved, implantation rate, miscarriage rate, and multiple pregnancy rate.


RESULTS
Six randomized controlled trials were included. In all trials, the group of women treated with hMG had higher pregnancy rates. Pooling the five trials that used a long GnRH agonist protocol resulted in a higher clinical pregnancy rate for hMG compared with recombinant FSH (relative risk, 1.22 [95% CI, 1.03 to 1.44]). However, there was no evidence of a difference in rates of ongoing pregnancy or live birth per woman between hMG recipients and recombinant FSH recipients (relative risk, 1.20 [95% CI, 0.99 to 1.45]). No differences were found in gonadotropin dose used, oocytes retrieved, miscarriage rate, or multiple pregnancy rate.


CONCLUSIONS
Use of hMG resulted in higher clinical pregnancy rates than did use of recombinant FSH in IVF/ICSI cycles after GnRH agonist down-regulation in a long protocol.
van Wely
Madelon
M
Academic Medical Center, Amsterdam, The Netherlands. m.vanwely@amc.uva.nl
Westergaard
Lars G
LG
Bossuyt
Patrick M M
PM
van der Veen
Fulco
F
D000328:Adult; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D008596:Menotropins / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000627:therapeutic use; D020554:Sperm Injections, Intracytoplasmic
D005300:Fertility Agents, Female; D006728:Hormones; D011994:Recombinant Proteins; D008596:Menotropins; D005640:Follicle Stimulating Hormone