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Comparison between stimulation with highly purified hMG or recombinant FSH in patients undergoing IVF with GnRH antagonist protocol
Authors:Tal Shavit  Einat Shalom-Paz  Nivin Samara  Nardin Aslih  Madiea Michaeli  Adrian Ellenbogen
Affiliation:1. IVF Unit, Department of Obstetrics &2. Gynecology, Hillel Yaffe Medical Center, Rappaport School of Medicine, Technion, Israel Institute of Technology, Haifa, Hadera, IL, Israel
Abstract:Purpose: Highly purified Human Menopausal Gonadotropins (hp-hMG) and recombinant FSH (rFSH) are widely used in assisted reproductive technology (ART). The aim of this study was to compare ART results of the two preparations in GnRH antagonist cycles.

Methods: In this retrospective cohort study, IVF antagonist cycles performed from 2011 through 2013 were reviewed. There were 508 antagonist cycles: 320 stimulated with rFSH and 188 with hp-hMG. For every hp-hMG, two rFSH were matched for patient's age and infertility diagnosis. Subgroup analysis of patients younger and older than 35 was done as well.

Results: Both treatments were resulted in comparable pregnancy and live birth rates. However, cumulative pregnancy rates were higher for the rFSH group. In the matching analysis, the rFSH group had more mature oocytes and more embryos while using lower doses of gonadotropins. Pregnancy, cumulative pregnancy rates, and live birth rates were comparable. In the subgroup analysis, young patients in the rFSH group had better cycle outcomes compared with those in the hp-hMG group.

Conclusion: In antagonist protocol, different gonadotropin products are equally effective. The choice of one or the other should depend on the availability, convenience of use, and cost.

Keywords:Antagonist protocol  assisted reproductive technology  infertility  ovulation induction
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