title: The rate of high ovarian response in women identified at risk by a high serum AMH level is influenced by the type of gonadotropin.
abstract: The aim was to compare ovarian response and clinical outcome of potential high-responders after stimulation with highly purified menotropin (HP-hMG) or recombinant follicle-stimulating hormone (rFSH) for in vitro fertilisation/intracytoplasmic sperm injection. Retrospective analysis was performed on data collected in two randomized controlled trials, one conducted following a long GnRH agonist protocol and the other with an antagonist protocol. Potential high-responders (n = 155 and n = 188 in the agonist and antagonist protocol, respectively) were defined as having an initial anti-Müllerian hormone (AMH) value >75th percentile (5.2 ng/ml). In both protocols, HP-hMG stimulation in women in the high AMH category was associated with a significantly lower occurrence of high response (≥15 oocytes retrieved) than rFSH stimulation; 33% versus 51% (p = 0.025) and 31% versus 49% (p = 0.015) in the long agonist and antagonist protocol, respectively. In the potential high-responder women, trends for improved live birth rate were observed with HP-hMG compared with rFSH (long agonist protocol: 33% versus 20%, p = 0.074; antagonist protocol: 34% versus 23%, p = 0.075; overall population: 34% versus 22%, p = 0.012). In conclusion, the type of gonadotropin used for ovarian stimulation influences high-response rates and potentially clinical outcome in women identified as potential high-responders.
authors.affiliation: Reproductive Health, Ferring Pharmaceuticals A/S , Copenhagen , Denmark .
authors.forename: Joan-Carles
authors.initials: JC
authors.lastname: Arce
authors.forename: Bjarke M
authors.initials: BM
authors.lastname: Klein
authors.forename: Antonio
authors.initials: A
authors.lastname: La Marca
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects*; D005307:Fertilization in Vitro; D043373:Follicle Stimulating Hormone, Human / Q000009:adverse effects* / Q000235:genetics; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000037:antagonists & inhibitors; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D050498:Live Birth; D008596:Menotropins / Q000009:adverse effects*; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood / Q000453:epidemiology*; D010053:Ovary / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D011994:Recombinant Proteins / Q000009:adverse effects; D012189:Retrospective Studies; D012306:Risk; D020554:Sperm Injections, Intracytoplasmic; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D054304:Anti-Mullerian Hormone
keywords: GnRH agonist; GnRH antagonist; gonadotropins; live birth; ovarian response