Publication:

To compare the effectiveness of recombinant gonadotropin versus the combination of recombinant follicle stimulating hormone and highly purified human menopausal gonadotropin versus urinary human menopausal gonadotropin alone for ovarian stimulation in women undergoing in vitro fertilisation or intracytoplasmic sperm injection treatment cycles

Background The question of the dominance of recombinant FSH(r FSH) for controlled ovarian stimulation (COS) in in-vitro fertilization (IVF) is not yet defined. Cheaper and equally efficient drugs for COS are valuable for the poor infertile couple.

Methods This retrospective study includes total of 371 fresh, non-donor, IVF cycles with COS excluding PCOS, endometriosis and poor ovarian reserve patients. To minimize the bias, only the first cycle for each patient below 40 years old, in one year period (Jan 2014 to Dec 2014) was analyzed. This selection comprised of respondents in 3 groups i.e. rFSH n= 132, HP-HMG +rFSH, n=141 and uHMG, n=98. The primary outcome studied as the result of COS are the mean number of retrieved oocytes and mature oocytes, fertilization rate, mean number of good quality embryos, and -cryopreserved embryos. The secondary outcome was the clinical pregnancy rates and the delivery rates.

Results The current studies do not demonstrate significant differences in duration and dosage of gonadotropins required and clinical outcome of treatment in patients in all 3 groups. We found significant higher E2 levels &better quality oocytes an embryo in patients treated with uHMG and combination groups & significantly increased number of cryopreserved embryos in uHMG group. Lower cancellation rates in rFSH group and HMG group. OHSS rates were similar in all 3 groups.

Conclusions Treatment with uHMG or with combination could achieve the same results and reduce the whole cost of stimulation in comparison with rFSH.