title: Clinical efficacy of recombinant versus highly purified follicle-stimulating hormone according to follicle-stimulating hormone receptor genotype.
abstract: Conflicting data have been reported on the comparative doses of recombinant follicle-stimulating hormone (rFSH) and urinary highly purified follicle-stimulating hormone (HP-FSH) required for ovarian stimulation. Nothing is known about the clinical efficacy of rFSH or HP-FSH depending on the N680S follicle-stimulating hormone receptor (FSHR) polymorphism. Our aim was to investigate whether the N680S polymorphism of the FSHR gene affects ovarian response with different forms of FSH.
  
  
  
  This retrospective cohort study includes 382 cycles performed at Instituto Bernabeu from 191 oocyte donors. All donors carried out two cycles: one with rFSH and the other one with HP-FSH (group 1, n=63), both with HP-FSH (group 2, n=100) or both with rFSH (group 3, n=28). The results were compared by pairs from each patient. The main outcomes were oocyte yield, metaphase II matured oocytes (MII), days of stimulation, and gonadotropin dosage.
  
  
  
  No significant differences were found when we compared the cycles for donors in group 1. However, according to the FSHR polymorphism, statistical differences were shown. For the SS genotype, more oocytes (16.9 vs. 18.4) and MII (12.8 vs. 15.5) were yielded in the HP-FSH cycle. For the NS genotype, more oocyte (20.1 vs. 16.9) and MII (17.4 vs. 14.2) were yielded in the rFSH cycle. For the NN genotype, no differences were found. No differences were found when we compared the cycles in groups 2 and 3 irrespective of the FSHR polymorphism.
  
  
  
  For the first time, we have shown in a population of egg donors that the N680S FSHR gene polymorphism affects the efficacy of HP-FSH or rFSH. The FSHR genotype is an important factor to determine the dosage and the nature of the gonadotropin selected for ovarian stimulation.
authors.affiliation: aMolecular Biology Department, IB Biotech bReproductive Medicine Department, Instituto Bernabeu of Fertility and Gynecology, Alicante, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Lledó
authors.forename: Patricia
authors.initials: P
authors.lastname: Dapena
authors.forename: Jose A
authors.initials: JA
authors.lastname: Ortiz
authors.forename: Ruth
authors.initials: R
authors.lastname: Morales
authors.forename: Joaquín
authors.initials: J
authors.lastname: Llacer
authors.forename: Rafael
authors.initials: R
authors.lastname: Bernabeu
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D005838:Genotype; D006728:Hormones / Q000008:administration & dosage*; D006801:Humans; D009865:Oocytes / Q000166:cytology* / Q000187:drug effects / Q000378:metabolism; D010062:Ovulation Induction / Q000379:methods; D011110:Polymorphism, Genetic / Q000235:genetics*; D011962:Receptors, FSH / Q000235:genetics*; D011994:Recombinant Proteins / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006728:Hormones; D011962:Receptors, FSH; D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone