Human Reproduction, Vol. 18, No. 2, 305-313,
February 2003
© 2003 European Society of Human Reproduction and Embryology
Meta-analysis of recombinant versus urinary-derived FSH: an update
1 The Egyptian IVF-ET Center, Maadi, Cairo and 2 Cairo University, Department of Obstetrics and Gynecology, Cairo, Egypt
3 To whom correspondence should be addressed at: The Egyptian IVF-ET Center, 3 Street 161, Hadayek El-Maadi, Maadi, Cairo 11431, Egypt. e-mail: ivf{at}link.net
BACKGROUND: The study aim was to analyse the results of randomized controlled trials (RCTs) comparing recombinant FSH and urinary-derived FSH gonadotrophins [hMG, urinary purified FSH (FSH-P) and highly purified FSH (FSH-HP)] in an IVF/ICSI programme. METHODS: All published truly RCTs using a long protocol of GnRH agonists for down-regulation, were reviewed. Data of pregnancy rate per started cycle were extracted, and odds ratios (OR) calculated using a fixed effect model. Subgroup analysis was carried out to compare recombinant FSH (rFSH) with each product (hMG alone, FSH-P alone and FSH-HP alone). RESULTS: There was no statistically significant difference in the pregnancy rate per started cycle between rFSH and urinary-derived FSH gonadotrophins (OR 1.07; 95% CI 0.94–1.22). Subgroup analysis showed no statistically significant difference in the pregnancy rate per started cycle between rFSH versus hMG (OR 0.81; 95% CI 0.63–1.05), rFSH versus FSH-P (OR 1.24; 95% CI 0.98–1.58) and rFSH versus FSH-HP (OR 1.14; 95% CI 0.94–1.40). There was no significant heterogeneity of treatment effect across the trials. CONCLUSIONS: There is no evidence of clinical superiority in clinical pregnancy rate for rFSH over different urinary-derived FSH gonadotrophins. Additional factors should be considered when choosing a gonadotrophin regimen, including the cost, patient acceptability, safety and drug availability.
Key words: meta-analysis/ovarian stimulation/RCTs/recombinant FSH/urinary FSH
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