title: Human recombinant follicle stimulating hormone (rFSH) compared to urinary human menopausal gonadotropin (HMG) for ovarian stimulation in assisted reproduction: a literature review and cost evaluation.
abstract: BACKGROUND
  Gonadotropins are protein hormones which are central to the complex endocrine system that regulates normal growth, sexual development, and reproductive function. There is still a lively debate on which type of gonadotropin medication should be used, either human menopausal gonadotropin or recombinant follicle-stimulating hormone. The objective of the study was to perform a systematic review of the recent literature to compare recombinant follicle-stimulating hormone to human menopausal gonadotropin with the aim to assess any differences in terms of efficacy and to provide a cost evaluation based on findings of this systematic review.
  
  
  METHODS
  The review was conducted selecting prospective, randomized, controlled trials comparing the two gonadotropin medications from a literature search of several databases. The outcome measure used to evaluate efficacy was the number of oocytes retrieved per cycle. In addition, a cost evaluation was performed based on retrieved efficacy data.
  
  
  RESULTS
  The number of oocytes retrieved appeared to be higher for human menopausal gonadotropin in only 2 studies while 10 out of 13 studies showed a higher mean number of oocytes retrieved per cycle for recombinant follicle-stimulating hormone. The results of the cost evaluation provided a similar cost per oocyte for both hormones.
  
  
  CONCLUSIONS
  Recombinant follicle-stimulating hormone treatment resulted in a higher oocytes yield per cycle than human menopausal gonadotropin at similar cost per oocyte.
authors.affiliation: Humanitas Fertility Center, Division of Gynaecology and Reproductive Medicine, Department of Gynaecology, Humanitas Research Hospital, Rozzano, Milan, Italy.
authors.forename: P E
authors.initials: PE
authors.lastname: Levi Setti
authors.affiliation: Dipartimento Universitario di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli, "Federico II", Naples, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Alviggi
authors.affiliation: Department of Drug Sciences, University of Pavia, Pavia, Italy.|S.A.V.E. Studi Analisi Valutazioni Economiche, Milan, Italy.
authors.forename: G L
authors.initials: GL
authors.lastname: Colombo
authors.affiliation: Hospital Pharmacist, ACO San Filippo Neri, Rome, Italy.|Società Italiana Di Farmacia Ospedaliera, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pisanelli
authors.affiliation: CSD Medical Research Srl, Viale Jenner n 53, 20159, Milan, Italy. claudio.ripellino@cegedim.com.
authors.forename: C
authors.initials: C
authors.lastname: Ripellino
authors.affiliation: Medical Department, MerckSerono S.p.A, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Longobardi
authors.affiliation: Dipartimento di Scienze del Farmaco, Università del Piemonte Orientale, Largo Donegani 2, Novara, Italy.
authors.forename: P L
authors.initials: PL
authors.lastname: Canonico
authors.affiliation: University Department of Obstetrics, Gynaecology, Urology and Reproductive Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: De Placido
mesh_terms: D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D008596:Menotropins / Q000191:economics / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care / Q000191:economics; D010062:Ovulation Induction / Q000191:economics / Q000379:methods
chemical_list: D043373:Follicle Stimulating Hormone, Human; D008596:Menotropins
keywords: Assisted reproduction; Cost evaluation; FSH; Gonadotropins; HMG; Human menopausal gonadotropin; Infertility; Recombinant follicle stimulating hormone; Systematic review