Could the addition of hp-hMG and GnRH antagonists modulate the response in IVF-ICSI cycles?

Hum Fertil (Camb). 2010 Mar;13(1):41-9. doi: 10.3109/14647270903586356.

Abstract

Objective: To assess if the luteinizing hormone/human chorionic gonadotropin present in some gonadotropin formulations may be of benefit in protocols with GnRH antagonists.

Methods: Open, quasi-experimental, multicenter, prospective, parallel-controlled study compared 136 women undergoing in vitro fertilization--intracytoplasmic sperm injection after stimulation with highly purified human menopausal gonadotropin (hp-hMG) (n = 44), recombinant-follicle stimulating hormone (r-FSH) (n = 46), or a combination of both (r FSH + hp-hMG) (n = 46) following an antagonist protocol. Blood determinations were made on day 6 of stimulation and on the day of ovulation induction, with centralized analysis.

Results: No differences were found in the ongoing pregnancy rates between groups [37.0% versus 29.5% (hp-hMG) and 23.9% (r-FSH); p = 0.688]. However, the ratio top-quality embryos/retrieved oocytes (TQE/RO) was higher in the combined therapy group (19.6%)--reaching significance versus the r-FSH group (6.5%) (p = 0.008), but not versus hp-hMG (12.3%) (p = 0.137).

Conclusions: An improved TQE/RO ratio was obtained together with a greater percentage of frozen embryos in the patients that incorporated hp-hMG to their stimulation protocol. Despite good results of adding hp-hMG, non statistical differences were found in terms of ongoing pregnancy rate.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Chi-Square Distribution
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Fertility Agents, Female / administration & dosage
  • Follicle Stimulating Hormone, Human / administration & dosage*
  • Gonadotropin-Releasing Hormone / administration & dosage
  • Gonadotropin-Releasing Hormone / analogs & derivatives*
  • Humans
  • Infertility, Female / drug therapy*
  • Menotropins / administration & dosage*
  • Oocyte Retrieval
  • Ovulation Induction / methods*
  • Patient Selection
  • Pregnancy
  • Pregnancy Rate
  • Prospective Studies
  • Regression Analysis
  • Sperm Injections, Intracytoplasmic / methods*
  • Treatment Outcome

Substances

  • Fertility Agents, Female
  • Follicle Stimulating Hormone, Human
  • Gonadotropin-Releasing Hormone
  • Menotropins
  • ganirelix