Human Reproduction, Vol 13, 1783-1787, Copyright © 1998 by Oxford University Press
S Jacob, L Drudy, R Conroy and RF Harrison
In the absence of specific dose equivalency data, the aim of this study was
to compare the clinical results during the cross-over from menopausal
urinary products (human menopausal gonadotrophin; HMG) to recombinant
follicle stimulating hormone (FSH) follitrophin beta (FSHr) in order to
determine whether the manufacturer's recommendation for equivalence of
ampoule to ampoule (50 IU FSHr:75 IU HMG) would prove clinically correct. A
total of 353 consecutive in-vitro fertilization (IVF)/intracytoplasmic
sperm injection (ICSI) treatment cycles was studied between 1st September
1996 and mid-February 1997. This included cycles in the last 191 women
receiving HMG and the first 162 taking FSHr. All were down-regulated using
a gonadotrophin releasing hormone (GnRH) agonist long protocol method from
day 1 of the cycle. Greater efficacy was seen in the HMG group in terms of
days of stimulation required, need to increase dosage, cycle
discontinuation, number of follicles punctured, the numbers of oocytes
retrieved and their quality. The hormonal response to stimulation assessed
by oestradiol concentrations on days 5, 8 and day of human chorionic
gonadotrophin (HCG) was significantly lower in the FSHr group. The ratio of
oestradiol per follicle and per oocyte was significantly lower in the FSHr
group. There was a highly significant increase in cost with FSHr therapy.
Clinical pregnancy rates were 14% per cycle with FSHr and 20% per cycle
with HMG.
ARTICLES
Outcome from consecutive in-vitro fertilization/intracytoplasmic sperm injection attempts in the final group treated with urinary gonadotrophins and the first group treated with recombinant follicle stimulating hormone
RCSI Department of Obstetrics and Gynaecology and Human Assisted Reproduction Ireland, Rotunda Hospital, Dublin.
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