Human recombinant follicle stimulating hormone (rFSH) compared to urinary human menopausal gonadotropin (HMG) for ovarian stimulation in assisted reproduction: a literature review and cost evaluation

J Endocrinol Invest. 2015 May;38(5):497-503. doi: 10.1007/s40618-014-0204-4. Epub 2014 Dec 6.

Abstract

Background: Gonadotropins are protein hormones which are central to the complex endocrine system that regulates normal growth, sexual development, and reproductive function. There is still a lively debate on which type of gonadotropin medication should be used, either human menopausal gonadotropin or recombinant follicle-stimulating hormone. The objective of the study was to perform a systematic review of the recent literature to compare recombinant follicle-stimulating hormone to human menopausal gonadotropin with the aim to assess any differences in terms of efficacy and to provide a cost evaluation based on findings of this systematic review.

Methods: The review was conducted selecting prospective, randomized, controlled trials comparing the two gonadotropin medications from a literature search of several databases. The outcome measure used to evaluate efficacy was the number of oocytes retrieved per cycle. In addition, a cost evaluation was performed based on retrieved efficacy data.

Results: The number of oocytes retrieved appeared to be higher for human menopausal gonadotropin in only 2 studies while 10 out of 13 studies showed a higher mean number of oocytes retrieved per cycle for recombinant follicle-stimulating hormone. The results of the cost evaluation provided a similar cost per oocyte for both hormones.

Conclusions: Recombinant follicle-stimulating hormone treatment resulted in a higher oocytes yield per cycle than human menopausal gonadotropin at similar cost per oocyte.

Keywords: Assisted reproduction; Cost evaluation; FSH; Gonadotropins; HMG; Human menopausal gonadotropin; Infertility; Recombinant follicle stimulating hormone; Systematic review.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Female
  • Follicle Stimulating Hormone, Human* / economics
  • Follicle Stimulating Hormone, Human* / therapeutic use
  • Humans
  • Menotropins* / economics
  • Menotropins* / therapeutic use
  • Outcome Assessment, Health Care* / economics
  • Ovulation Induction* / economics
  • Ovulation Induction* / methods

Substances

  • Follicle Stimulating Hormone, Human
  • Menotropins