title: Influence of ovarian stimulation with HP-hMG or recombinant FSH on embryo quality parameters in patients undergoing IVF.
abstract: 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.
authors.affiliation: Fertility Clinic, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark. soeren.ziebe@rh.hosp.dk
authors.forename: Søren
authors.initials: S
authors.lastname: Ziebe
authors.forename: Kersti
authors.initials: K
authors.lastname: Lundin
authors.forename: Ronny
authors.initials: R
authors.lastname: Janssens
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Helmgaard
authors.forename: Joan-Carles
authors.initials: JC
authors.lastname: Arce
mesh_terms: 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*
chemical_list: D011994:Recombinant Proteins; D008596:Menotropins; D005640:Follicle Stimulating Hormone