Endocrine profile in serum and follicular fluid differs after ovarian stimulation with HP-hMG or recombinant FSH in IVF patients

Hum Reprod. 2007 Mar;22(3):676-87. doi: 10.1093/humrep/del445. Epub 2006 Nov 16.

Abstract

Background: Highly purified menotrophin (HP-hMG) has been associated with fewer oocytes retrieved and a higher proportion of top-quality embryos compared with recombinant FSH (rFSH).

Methods: A randomized, assessor-blind, multinational trial in 731 women undergoing IVF after stimulation with HP-hMG (MENOPUR) (n = 363) or rFSH (GONAL-F) (n = 368) following a long GnRH agonist protocol was conducted. Blood was collected before, during and after stimulation. Fluid was collected from follicles > or =17 mm.

Results: Serum androstenedione, total testosterone and free androgen index (FAI) were higher (P < 0.001) with HP-hMG than with rFSH after starting stimulation. At the end of stimulation, serum estradiol was higher (P = 0.031) with HP-hMG, whereas progesterone was higher (P < 0.001) with rFSH, even after adjusting for ovarian response. Serum LH was not different between treatments. Mean mid- and end-follicular hCG levels in the HP-hMG group were 2.5 and 2.9 IU/l, respectively. Follicular fluid levels of FSH, LH, hCG, androstenedione, testosterone, FAI and estradiol and ratios of estradiol:androstenedione, estradiol:total testosterone and estradiol:progesterone were higher (P < 0.001) with HP-hMG, whereas progesterone was higher (P < 0.001) with rFSH.

Conclusion: Major differences in serum and follicular fluid endocrine profile exist after stimulation with HP-hMG or rFSH. Exogenous LH activity induces a differential endocrine environment influencing oocyte quantity and quality, which may be of relevance for clinical outcome.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Androgens / analysis
  • Androgens / blood
  • Chorionic Gonadotropin / analysis
  • Chorionic Gonadotropin / blood
  • Estradiol / analysis
  • Estradiol / blood
  • Female
  • Fertilization in Vitro
  • Follicle Stimulating Hormone / therapeutic use*
  • Follicular Fluid / chemistry*
  • Humans
  • Menotropins / therapeutic use*
  • Ovarian Follicle / drug effects
  • Ovulation Induction / methods*
  • Progesterone / analysis
  • Progesterone / blood
  • Recombinant Proteins / therapeutic use
  • Treatment Outcome

Substances

  • Androgens
  • Chorionic Gonadotropin
  • Recombinant Proteins
  • Progesterone
  • Estradiol
  • Menotropins
  • Follicle Stimulating Hormone