Recombinant FSH Versus HP-HMG for Controled Ovarian Stimulation in Intracitoplasmic Sperm Injection Cycles

Abstract

The aim of this study was to make a conclusion about aplicability of two differnet gonadothropins in COS (rFSH versus HP-hMG). The primary conclusion for the success as a result of COS are the mean number of retrived oocytes, mature oocytes, fertilization rate, mean number of quality embrios, and criopreverzed embrios. The secondary conclusions were clinical pregnancy rate and delivery rates. Methods: The study was a retrospective case–control study,. A total of 1238 fresh, non donor, IVF cycles with COS were analyzed, but to minimize the bias, only the first cycle for each patient below 40 yaears old, in that period was analyzed. This selection composed the group of respondents that was analyzed which in total amounted to 760 patients.( rFSH = 422, HP-hMG = 338). The patients underwent COS by long luteal protocol using two differnt inducers of COS (rFSH and HP-hMG). Results: The average starting dose of rFSH used was significantely lower (152.7±41.1IU), whereas with HMG it was (228.8±68.7 IU, p=000000). The average number of IU gonadothropin used in therapy, statistically highly is significantly lower when r- FSH is used as an inducer. (1639.2 ± 476.9 IU, rFSH vs 2356.4 ± 955.1IU, HP–hMG, p <0.001). We received significantly higher average number of oocytes and mature oocytes in the group of r–FSH (oocytes; rFSH v HP-hMG–11.8 ± 7.1 v 10.7 ± 6.5, p = 0.028 ; mature oocytes: rFSH v HP-hMG 9.9 ± 6.2 v8.7 ± 5.5 p = 0.009). However, we did not find a significant difference in the use of the COS inductors regarding the clinical pregnancy rate (rFSH v HP-hMG 49.5% vs 48.9% p=0.92) and delivery rate (rFSH vs HP-hMG 42.9% vs 43.4% p=0.96). Conclusions: Our study showed that rFSH is more powerful and more applicable in individualized dosing then HP-hMG and brings better results from COS (more oocytes, more matured oocytes). Key words: Controled ovarian stimulation (KOS), rekominant folikulostimulative hormon (rFSH), high purity human menopausal gonadothropin (HP-hMG), intracitoplasmic sperm injection (ICSI), retrived oocytes.