Could the addition of hp-hMG and GnRH antagonists modulate the response in IVF-ICSI cycles?
OBJECTIVE
To assess if the luteinizing hormone/human chorionic gonadotropin present in some gonadotropin formulations may be of benefit in protocols with GnRH antagonists.


METHODS
Open, quasi-experimental, multicenter, prospective, parallel-controlled study compared 136 women undergoing in vitro fertilization--intracytoplasmic sperm injection after stimulation with highly purified human menopausal gonadotropin (hp-hMG) (n = 44), recombinant-follicle stimulating hormone (r-FSH) (n = 46), or a combination of both (r FSH + hp-hMG) (n = 46) following an antagonist protocol. Blood determinations were made on day 6 of stimulation and on the day of ovulation induction, with centralized analysis.


RESULTS
No differences were found in the ongoing pregnancy rates between groups [37.0% versus 29.5% (hp-hMG) and 23.9% (r-FSH); p = 0.688]. However, the ratio top-quality embryos/retrieved oocytes (TQE/RO) was higher in the combined therapy group (19.6%)--reaching significance versus the r-FSH group (6.5%) (p = 0.008), but not versus hp-hMG (12.3%) (p = 0.137).


CONCLUSIONS
An improved TQE/RO ratio was obtained together with a greater percentage of frozen embryos in the patients that incorporated hp-hMG to their stimulation protocol. Despite good results of adding hp-hMG, non statistical differences were found in terms of ongoing pregnancy rate.
Requena
Antonio
A
IVI Madrid, Madrid, Spain. arequena@ivi.es
Landeras
José L
JL
Martínez-Navarro
Luis
L
Calatayud
Carmen
C
Sánchez
Fernando
F
Maldonado
Vicente
V
Muñoz
Manuel
M
Fernández
Manuel
M
González
Alejandro
A
López
Setefilla
S
López
Rocío
R
Pacheco
Alberto
A
Calderón
Gloria
G
Martínez
Vicente
V
D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D043373:Follicle Stimulating Hormone, Human / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D008596:Menotropins / Q000008:administration & dosage*; D054315:Oocyte Retrieval; D010062:Ovulation Induction / Q000379:methods*; D018579:Patient Selection; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012044:Regression Analysis; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; C061018:ganirelix