Human Reproduction, Vol 13, 2995-2999, Copyright © 1998 by Oxford University Press
CA Jansen, HC van Os, HJ Out and HJ Coelingh Bennink
A randomized clinical trial was performed comparing recombinant follicle
stimulating hormone (rFSH, Puregon, n = 54) and human menopausal
gonadotrophin (HMG, Humegon, n = 35) in infertile women undergoing in-vitro
fertilization without the use of a gonadotrophin- releasing hormone (GnRH)
agonist. Most patients had a tubal or idiopathic infertility, the latter
always longer than 4 years' duration. Patients with sperm abnormalities
were excluded. None of the between-group differences in treatment outcome
was statistically significant. In the rFSH group, a mean number of 11.2
oocytes was retrieved compared with 8.3 in the HMG group. Ongoing pregnancy
rates per started cycle were higher in the rFSH group (22.2%) than in the
HMG group (17.1%). Implantation rates were 27.5% in the rFSH group in
comparison with 16.7% in the HMG group. In the rFSH group, a mean total
dose of 1410 IU during 6.2 days was administered compared with 1365 IU in
6.0 days in the HMG group. Oestradiol concentrations on the day of human
chorionic gonadotrophin administration were 3889 pmol/l in the rFSH group
and 3145 pmol/l in the HMG group. In 15 subjects (rFSH: n = 9, 16.7%; HMG:
n = 6, 17.1%) luteinizing hormone concentrations higher than 10 IU/l were
seen during stimulation. In two of them, both from the rFSH group, ongoing
pregnancies were achieved. The results indicate that rFSH (Puregon) is at
least as efficacious as HMG and that acceptable pregnancy rates can be
achieved without the use of a GnRH agonist.
ARTICLES
A prospective randomized clinical trial comparing recombinant follicle stimulating hormone (Puregon) and human menopausal gonadotrophins (Humegon) in non-down-regulated in-vitro fertilization patients
Reinier de Graafgroep, Diaconessenhuis Voorburg/Delft, Oss, The Netherlands.
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