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Comparative Study
. 2015 Jul 25:13:77.
doi: 10.1186/s12958-015-0080-6.

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

Alberto Revelli  1   2 , Grazia Pettinau  3 , Gemma Basso  4 , Andrea Carosso  5 , Alessandro Ferrero  6 , Cecilia Dallan  7 , Stefano Canosa  8 , Gianluca Gennarelli  9   10 , Daniela Guidetti  11 , Claudia Filippini  12 , Chiara Benedetto  13
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Free PMC article
Comparative Study

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

Alberto Revelli et al. Reprod Biol Endocrinol. .
Free PMC article

Abstract

Background: The 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.

Methods: Eight 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).

Results: Overall, 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.

Conclusions: When 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.

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Figures

Fig. 1
Fig. 1
Pregnancy rate per embryo transfer (PR/ET) in subgroups of patients stratified according to the number retrieved oocytes (a) or to the number of mature (MII) oocytes (b). Pale columns correspond to patients who received rFSH + rLH/2:1 (Group A, n = 398), dark columns to patients who received hMG (Group B, n = 450). *p = 0.0038; **p = 0.013
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