Ovarian stimulation protocols based on follicle-stimulating hormone glycosylation pattern: impact on oocyte quality and clinical outcome.
OBJECTIVE
To evaluate the impact of follicle-stimulating hormone (FSH) with different glycosylation patterns on oocyte quality and clinical outcomes in an in vitro fertilization (IVF) treatment program.


METHODS
Prospective randomized, open-label, clinical study.


METHODS
Assisted reproduction center.


METHODS
One hundred eighty-eight infertile couples undergoing assisted fertilization treatment.


METHODS
All participants underwent a standard down-regulation with a gonadotropin-releasing hormone (GnRH) analogue. The patients were randomized into three groups: 63 patients received combined sequential acidic and less-acidic FSH, 65 patients received only less-acidic FSH (recombinant FSH), and 60 received only acidic FSH (human-derived FSH).


METHODS
Number of mature metaphase II oocytes, embryo quality, clinical pregnancy rates, and implantation rates.


RESULTS
The pregnancy and implantation rates were statistically significantly lower in the less-acidic recombinant FSH alone group than in the combined sequential acidic hFSH/less-acidic recombinant FSH, and acidic hFSH alone groups (33.3%, 43.5%, 39% and 17.3%, 24.5%, 20.4%, respectively). Metaphase II oocytes and grade 1 embryos were statistically significantly higher in favor of the combined sequential acidic hFSH/less-acidic recombinant FSH group compared with the less-acidic recombinant FSH alone group.


CONCLUSIONS
The glycosylation patterns of the two types of FSH implemented for ovarian stimulation have different impacts on oocyte quality and clinical outcome. A sequential combined protocol using both acidic and less-acidic FSH for ovarian stimulation improves oocyte maturity and embryo cleavage, and increases pregnancy and implantation rates.
Selman
Helmy
H
Praxi Provita, Rome, Italy. selman@yahoo.com
Pacchiarotti
Arianna
A
El-Danasouri
Imam
I
D000328:Adult; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D005640:Follicle Stimulating Hormone / Q000378:metabolism / Q000494:pharmacology*; D006031:Glycosylation; D006801:Humans; D009865:Oocytes / Q000187:drug effects* / Q000502:physiology*; D006080:Ovarian Follicle / Q000187:drug effects / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies
D005640:Follicle Stimulating Hormone