Controlled Ovarian Stimulation with recombinant-FSH plus recombinant-LH vs. human Menopausal Gonadotropin based on the number of retrieved oocytes: results from a routine clinical practice in a real-life population

Reproductive Biology and Endocrinology

Research

Gemma Basso¹  Alessandro Ferrero¹  Stefano Canosa¹  Chiara Benedetto¹  Cecilia Dallan¹  Grazia Pettinau¹  Andrea Carosso¹  Alberto Revelli²  Gianluca Gennarelli²  Daniela Guidetti³  Claudia Filippini⁴ 

[1] Gynecology and Obstetrics, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, University of Torino, S. Anna Hospital, Torino, Italy;Gynecology and Obstetrics, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, University of Torino, S. Anna Hospital, Torino, Italy;LIVET Infertility and IVF Clinic, Torino, Italy;LIVET Infertility and IVF Clinic, Torino, Italy;Statistics, Department of Surgical Sciences, University of Torino, MolinetteHospital, Torino, Italy;

关键词: Recombinant FSH;    Recombinant LH;    Human menopausal gonadotropin;    In vitro fertilization;    IVF outcome;    Pregnancy rate;   

DOI  :  10.1186/s12958-015-0080-6

 received in 2015-04-03, accepted in 2015-07-21,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe association of recombinant FSH (rFSH) plus recombinant LH (rLH) is currently used for Controlled Ovarian Stimulation (COS) in human IVF, but its efficacy has, to date, not yet been compared to that of human Menopausal Gonadotropin (hMG), the FSH + LH activity-containing urinary drug.MethodsEight hundred forty-eight (848) IVF patients classified as expected “poor” or “normal” responders according to antral follicle count (AFC) and basal (day 3) FSH were treated with rFSH + rLH (2:1 ratio, n = 398, Group A) or hMG (n = 450, Group B). Data were collected under real-life practice circumstances and the pregnancy rate with fresh embryos was calculated by stratifying patients according to the number of retrieved oocytes (1–2, 3–4, 5–6, 7–8, >8).ResultsOverall, the pregnancy rate in both groups progressively improved according to the number of oocytes retrieved. When comparing patients within the same subgroup of oocyte yield, Group A and B showed a comparable outcome up to the reported highest yield (>8). When more than 8 oocytes were available, Group A had a significantly better pregnancy rate outcome. Patients’ characteristics did not significantly differ between the two groups and the better outcome in the best responding patients in Group A was confirmed by a multivariable logistic regression analysis, that showed that both the use of rFSH + rLH and the total number of retrieved oocytes increased the probability of pregnancy with odd ratio (OR) of 1.628 and 1.083, respectively.ConclusionsWhen comparing patients with the same number of retrieved oocytes under real-life circumstances, the association of rFSH + rLH results in a significantly higher pregnancy rate than hMG when more than 8 oocytes are retrieved. The reason(s) for this are unknown, but a more favorable effect on oocyte quality and/or endometrial receptivity could be involved.

【 授权许可】

CC BY   
© Revelli et al. 2015