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Hum. Reprod. Advance Access originally published online on July 19, 2007
Human Reproduction 2007 22(9):2404-2413; doi:10.1093/humrep/dem221
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
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Influence of ovarian stimulation with HP-hMG or recombinant FSH on embryo quality parameters in patients undergoing IVF

Søren Ziebe1,5, Kersti Lundin2, Ronny Janssens3, Lisbeth Helmgaard4, Joan-Carles Arce for the MERIT (Menotrophin vs Recombinant FSH in vitro Fertilisation Trial) Group4

1 Fertility Clinic, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark 2 Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden 3 Center for Reproductive Medicine of the Vrije Universiteit Brussel, Brussels, Belgium 4 Ferring Pharmaceuticals A/S, Obstetrics and Gynaecology, Clinical Research and Development, Copenhagen, Denmark

5 Correspondence address. Tel: +45-3545-4997; Fax: +45-3545-4099; E-mail: soeren.ziebe{at}rh.hosp.dk

BACKGROUND: There are limited data on the impact of different gonadotrophin preparations on embryo quality.

METHODS: This evaluation was part of a randomized, assessor-blind, multinational trial, conducted in 731 women undergoing IVF after stimulation with highly purified human menopausal gonadotropin (HP-hMG; MENOPUR) (n = 363) or recombinant FSH (rFSH; GONAL-F) (n = 368). Ongoing pregnancy was the primary end-point [HP-hMG 27% and rFSH 22%; odds ratio (OR) (95% confidence interval, CI) 1.25 (0.89-1.75)]. All 7535 oocytes retrieved were evaluated daily until day 3 (embryo transfer) in a blinded manner both by local site embryologists and a central panel of three embryologists.

RESULTS: The proportion of top-quality embryos per oocyte retrieved was higher with HP-hMG (11.3%) compared with rFSH (9.0%) (P = 0.044) in the local assessment, but comparable in the central assessment (9.5 and 8.0%, respectively). Significant differences in favour of HP-hMG were observed for number of blastomeres and degree of fragmentation, while uniformity of blastomere sizes, localization of fragments, frequency of multinucleation and homogeneous cytoplasm were comparable between HP-hMG and rFSH. The live birth, ongoing pregnancy and ongoing implantation rates for top-quality embryos were higher with HP-hMG than rFSH [48 versus 32% (P = 0.038), 48 versus 32% (P = 0.038), 41 versus 27% (P = 0.032)]. Both the proportion of embryos with at least 50% surviving blastomeres after cryopreservation and embryos resuming mitosis were more frequent with HP-hMG compared with rFSH.

CONCLUSIONS: Composition of gonadotrophin preparations used during ovarian stimulation has an impact on some embryo quality parameters. The capacity to implant of the top-quality embryos derived from stimulation with HP-hMG appears to be improved, although the mechanism needs to be elucidated.

Key words: embryo quality/IVF/rFSH/HP-hMG

Submitted on January 16, 2007; resubmitted on May 23, 2007; accepted on June 21, 2007.


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E. Bosch, C. Vidal, E. Labarta, C. Simon, J. Remohi, and A. Pellicer
Highly purified hMG versus recombinant FSH in ovarian hyperstimulation with GnRH antagonists--a randomized study
Hum. Reprod., June 25, 2008; (2008) den220v1.
[Abstract] [Full Text] [PDF]


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