Effectiveness of highly purified human menopausal gonadotropin vs. recombinant follicle-stimulating hormone in first-cycle in vitro fertilization-intracytoplasmic sperm injection patients.
OBJECTIVE
To compare the effectiveness of highly purified hMG with recombinant FSH (rFSH) in IVF-intracytoplasmic sperm injection patients who were treated with a GnRH agonist.


METHODS
An open-label, prospective, randomized comparison of fixed gonadotropin regimens.


METHODS
Eighteen Dutch IVF centers.


METHODS
Six hundred twenty-nine patients who were selected for IVF-intracytoplasmic sperm injection.


METHODS
Patients were randomized to receive either highly purified hMG or rFSH in a fixed dosage of 150 IU/d after GnRH-agonist suppression (long protocol).


METHODS
Ongoing pregnancy rate per started cycle. Difference between the two treatment groups was tested by using odds ratios, including the 95% confidence limits (intention-to-treat sample), and by using the Fisher's exact test (per-protocol sample).


RESULTS
The ongoing pregnancy rates per started cycle were 26.3% and 25.2% for highly purified hMG and rFSH, respectively (no statistically significant difference). Treatment with highly purified hMG resulted in statistically significantly fewer oocytes (n = 7.8) than did treatment with rFSH (n = 10.6). There were no differences with respect to fertilization rates and implantation rates. Cycles with highly purified hMG were statistically significantly less often canceled as a result of ovarian hyperresponse (2.0% vs. 6.0% for highly purified hMG and rFSH, respectively).


CONCLUSIONS
Compared with rFSH, highly purified hMG did not result in superiority in ongoing pregnancy rates in first-cycle IVF-intracytoplasmic sperm injection patients who were treated with a fixed dosage of 150 IU of gonadotropin per day. Compared with rFSH, treatment with highly purified hMG resulted in retrieval of fewer oocytes, a lower incidence of hyperresponse, and comparable pregnancy rates.
Hompes
Peter G A
PG
Vrije Universiteit Medical Centre, Amsterdam, The Netherlands. p.hompes@vumc.nl
Broekmans
Frank J
FJ
Hoozemans
Diederik A
DA
Schats
Roel
R
D000328:Adult; D004624:Embryo Transfer; D005260:Female; D005306:Fertilization / Q000187:drug effects / Q000502:physiology; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008423:Maternal Age; D008596:Menotropins / Q000009:adverse effects / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods; D018579:Patient Selection; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*
D011994:Recombinant Proteins; D008596:Menotropins; D005640:Follicle Stimulating Hormone