Influence of ovarian stimulation with HP-hMG or recombinant FSH on embryo quality parameters in patients undergoing IVF.
BACKGROUND
There are limited data on the impact of different gonadotrophin preparations on embryo quality.


METHODS
This evaluation was part of a randomized, assessor-blind, multinational trial, conducted in 731 women undergoing IVF after stimulation with highly purified human menopausal gonadotropin (HP-hMG; MENOPUR) (n = 363) or recombinant FSH (rFSH; GONAL-F) (n = 368). Ongoing pregnancy was the primary end-point [HP-hMG 27% and rFSH 22%; odds ratio (OR) (95% confidence interval, CI) 1.25 (0.89-1.75)]. All 7535 oocytes retrieved were evaluated daily until day 3 (embryo transfer) in a blinded manner both by local site embryologists and a central panel of three embryologists.


RESULTS
The proportion of top-quality embryos per oocyte retrieved was higher with HP-hMG (11.3%) compared with rFSH (9.0%) (P = 0.044) in the local assessment, but comparable in the central assessment (9.5 and 8.0%, respectively). Significant differences in favour of HP-hMG were observed for number of blastomeres and degree of fragmentation, while uniformity of blastomere sizes, localization of fragments, frequency of multinucleation and homogeneous cytoplasm were comparable between HP-hMG and rFSH. The live birth, ongoing pregnancy and ongoing implantation rates for top-quality embryos were higher with HP-hMG than rFSH [48 versus 32% (P = 0.038), 48 versus 32% (P = 0.038), 41 versus 27% (P = 0.032)]. Both the proportion of embryos with at least 50% surviving blastomeres after cryopreservation and embryos resuming mitosis were more frequent with HP-hMG compared with rFSH.


CONCLUSIONS
Composition of gonadotrophin preparations used during ovarian stimulation has an impact on some embryo quality parameters. The capacity to implant of the top-quality embryos derived from stimulation with HP-hMG appears to be improved, although the mechanism needs to be elucidated.
Ziebe
Søren
S
Fertility Clinic, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark. soeren.ziebe@rh.hosp.dk
Lundin
Kersti
K
Janssens
Ronny
R
Helmgaard
Lisbeth
L
Arce
Joan-Carles
JC
D000328:Adult; D015925:Cryopreservation; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000033:anatomy & histology / Q000187:drug effects*; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone; D006801:Humans; D008596:Menotropins / Q000008:administration & dosage*; D010062:Ovulation Induction; D011994:Recombinant Proteins / Q000008:administration & dosage*
D011994:Recombinant Proteins; D008596:Menotropins; D005640:Follicle Stimulating Hormone