title: Recombinant FSH versus highly purified FSH in intrauterine insemination: systematic review and metaanalysis.
abstract: OBJECTIVE
  To compare the pregnancy rates (PRs) in intrauterine insemination (IUI) using recombinant FSH (rec-FSH) or highly purified urinary FSH (HP-FSH).
  
  
  METHODS
  Systematic review and metaanalysis.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  None.
  
  
  METHODS
  Electronic and manual searches.
  
  
  METHODS
  PR, per first cycle PR and per woman PR.
  
  
  RESULTS
  Six randomized trials (713 women, 1,581 cycles) were identified. In three the same doses of rec-FSH and HP-FSH were used ("equal dose" group), whereas in the other three the ratio HP-FSH:rec-FSH dose was 1.5. The global metaanalysis showed no differences in PRs. The PR per cycle was similar across the 1.5 ratio group (14.51% vs. 14.93%; relative risk [RR], 0.970; 95% confidence interval [CI], 0.687-1.369). However, the metaanalysis of the equal dose group, showed differences in the PR in favor of rec-FSH (16.36% vs. 12.31%; RR, 1.394; 95% CI, 1.004-1.936). Per woman PR analysis showed similar results (41.44% vs. 31.55%; RR, 1.273; 95% CI, 0.987-1.643). Per first cycle PR analysis showed a similar trend, although the difference did not reach significance (RR, 1.434; 95% CI, 0.934-2.203).
  
  
  CONCLUSIONS
  Rec-FSH was associated with higher per cycle PR than HP-FSH, when used at the same dose, whereas the PR were similar when the dose of rec-FSH was 50% lower.
authors.affiliation: Human Reproduction Unit, Department of Obstetrics and Gynecology, Hospital de Cruces, Pais Vasco University, Baracaldo, Vizcaya, Spain. roberto.matorras@osakidetza.net
authors.forename: Roberto
authors.initials: R
authors.lastname: Matorras
authors.forename: Carmen
authors.initials: C
authors.lastname: Osuna
authors.forename: Antonia
authors.initials: A
authors.lastname: Exposito
authors.forename: Lorena
authors.initials: L
authors.lastname: Crisol
authors.forename: José Ignácio
authors.initials: JI
authors.lastname: Pijoan
mesh_terms: D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000009:adverse effects; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000009:adverse effects / Q000302:isolation & purification / Q000627:therapeutic use*; D006801:Humans; D007315:Insemination, Artificial / Q000379:methods*; D008297:Male; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D014599:Uterus
chemical_list: D005300:Fertility Agents, Female; D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone