the influence of gonadotropins on clinico-biological icsi outcome: a retrospective comparative study rFsH vs HP-hmg

##plugins.themes.academic_pro.article.sidebar##

Published Nov 24, 2016
Download
pdf
Vol. 94 No. 6 (2016): Issue Jun 2016

##plugins.themes.academic_pro.article.main##

Abdeljalil Khlifi
Olfa Kacem
Maher Maroueni
Leila Elgoul
Samir Hidar
Meriem Fekih
Sassi Boughizane
Habib Essaidi
Lassad Ben Regaya
Mohamed Bibi
Mounir Ajina
Hedi Khairi

Abstract

Abstract:
Objective To investigate the difference in the outcome of ICSI-ET cycles among respondents patients, taking into account the molecule inducer of controlled ovarian stimulation: HP-hMG ou rFSH.
Patients and Methods A comparative retrospective study over 62 months including a total of 1005 infertile couples, divided into two groups: HP-HMG (n=125) and rFSH (n=880).
Results: The average numbers of retrieved oocytes and matures oocytes were significantly higher in rFSH group rFSH (7,94 ± 2,49, HP-HMG vs 9,05 ± 3,40, rFSH, p=0.0001and  3±2,68, HP-HMG vs 6,65±3,05 , rFSH, p=0,02 respectively). There was no statistically significant difference in the endometrial thickness and estradiol level on hCG injection day, the total amount of administrated gonadotropin and the duration of stimulation. In addition, we did not find a significant difference between the two groups regarding the fertilization, the maturation, the cleavage, top quality embryo, implantation, clinical pregnancy, multiple pregnancies, live birth and miscarriage rates. There was no case of severe ovarian hyperstimulation syndrome.
Conclusion: Inspite of a higher number of retrieved and mature oocytes obtained with rFSH, the latter showed no superiority over HP-hMG which seem to be equally efficient and safe for ICSI treatment cycles.

Keywords:

Controlled ovarian stimulation, recombinant FSH, HP-hMG, ICSI

##plugins.themes.academic_pro.article.details##

References

  1. Rossin B, Pouly JL, Belaisch-Allart J, de Mouzon J. Ovarian stimulation for IVF in France: Choice and results according to protocols and gonadotrophin. Gynecol Obstet Fertil. 2009; 37:864-72.
  2. Kolibianakis EM, Albano C, Kahn J, Camus M, Tournaye H, Van Steirteghem AC et al. Exposure to high levels of luteinizing hormone and estradiol in the early follicular phase of gonadotropin-releasing hormone antagonist cycles is associated with a reduced chance of pregnancy. Fertil Steril. 2003;79:873-80.
  3. Daya S, Gunby J. Recombinant versus urinary follicle stimulating hormone for ovarian stimulation in assisted reproduction. Hum Reprod. 1999;14:2207-15.
  4. Agrawal R, Holmes J, Jacobs HS. Follicle-stimulating hormone or human menopausal gonadotropin for ovarian stimulation in in vitro fertilization cycles: a meta-analysis. Fertil Steril 2000;73:338-43.
  5. Kilani Z, Dakkak A, Ghunaim S, Cognigni GE, Tabarelli C, Parmegiani L et al. A prospective randomized controlled trial comparing highly purified HMG with recombinant FSH in women undergoing ICSI: ovarian response and clinical outcome. Hum Reprod. 2003;18:1194-9.
  6. Andersen AN, Devroey P, Arce JC. Clinical outcome following stimulation with highly purified hMG or recombinant FSH in patients undergoing IVF: a randomized assessor-blind controlled trial. Hum Reprod 2006;21:3217-27.
  7. Strehler E, Abt M, El-Danasouri I, De Santo M, Sterzik K. Impact of recombinant follicle-stimulating hormone and human menopausal gonadotropins on in vitro fertilization outcome. Fertil Steril 2001; 75:332-6.
  8. Hompes PG, Broekmans FJ, Hoozemans DA, Schats R, FIRM group. Effectiveness of highly purified human menopausal gonadotropin vs. recombinant follicle-stimulating hormone in first-cycle in vitro fertilizationintracytoplasmic sperm injection patients. Fertil Steril 2008;89:1685-93.
  9. Al-Inany HG, Abou-Setta AM, Aboulghar MA, Mansour RT, Serour GI. HMG versus rFSH for ovulation induction in developing countries: a costeffectiveness analysis based on the results of a recent meta-analysis. RBM Online 2006;12:163-9.
  10. Al-Inany HG, Abou-Setta AM, Aboulghar MA, Mansour RT, Serour GI. Efficacy and safety of human menopausal gonadotrophins versus recombinant FSH: a meta-analysis. RBM Online 2008;16:81-8.
  11. Al-Inany HG, Abou-Setta AM, Aboulghar MA, Mansour RT, Serour GI. Highly purified hMG achieves better pregnancy rates in IVF cycles but not ICSI cycles compared with recombinant FSH: a meta-analysis. Gynecol Endocrinol 2009; 25:372-8.
  12. Sykes D, Out HJ, Palmer SJ, Vanloon J. the cost effectiveness of IVF in the UK: a comparison of three gonadotropin treatment. Hum Reprod. 2001; 16:2557-62.
  13. World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen, 5th edn. Geneva: World Health Organization; 2010
  14. Platteau P, Nyboe Andersen A, Loft A, Smitz J, Danglas P, Devroey P. Highly purified HMG versus recombinant FSH for ovarian stimulation in IVF cycles. RBM Online 2008;17:190-8.
  15. Bosch E, Vidal C, Labarta E, Remohi J, Pellicer A. Highly purified HMG versus recombinant FSH in ovarian hyperstimulation with GnRH antagonist - a randomized study.. Hum reprod 2008; 23:2346-51.
  16. Jansen CA, van Os HC, Out HJ, Coelingh Bennink HJ. A prospective randomized clinical trial comparing recombinant follicle stimulating hormone (Puregon) and human menopausal gonadotrophins (Humegon) in nondown- regulated in-vitro fertilization patients. Hum Reprod 1998; 13:2995-9.
  17. Ng EH, Lau EY, Yeung WS, Ho PC. HMG is as good as recombinant human FSH in terms of oocyte and embryo quality: a prospective randomized trial. Hum Reprod 2001; 16:319-25.
  18. Westergaard LG, Erb K, Laursen SB, Rex S, Rasmussen PE. Human menopausal gonadotropin versus recombinant follicle-stimulating hormone in normogonadotropic women down-regulated with a gonadotropin releasing hormone agonist who were undergoing in vitro fertilization and intracytoplasmic sperm injection: a prospective randomized study. Fertil Steril 2001;76:543-9.
  19. Platteau P, Smitz J, Albano C, Sorenzen P, Arce JC, Devroey P. Exogenous luteinizing hormone activity may influence the treatment outcome in in vitro fertilization but not in intracytoplasmic sperm injection cycles. Fertil Steril 2004 ; 81:1401- 4.
  20. European and Israeili Study Group on Highly Purified Menotropin versus Recombinant follicule stimulating Hormone. Efficacy and safety of highly purified menotropin versus recombinant follicule-stimulation/ intracytoplasmic sperm injection cycles: a randomized, comparative trial. Fertil Steril 2002;78: 520- 8.
  21. Coomarasamy A, Afnan M, Cheema D, van der Veen F, Bossuyt PM, van Wely M, Urinary hMG versus recombinant FSH for controlled ovarian hyperstimulation following an agonist long down-regulation protocol in IVF or ICSI treatment: a systematic review and meta-analysis. Hum Reprod. 2008; 23:310-5.
  22. Melo M, Bellver J, Garrido N, Meseguer M, Pellicer A, Remohí J, A prospective, randomized, controlled trial comparing three different gonadotropin regimens in oocyte donors: ovarian response, in vitro fertilization outcome, and analysis of cost minimization. Fertil Steril 2010;94:958-64.
  23. Foster R, Sergers I,Smart D, Adriaenssens T, Smitz J, Arce JC, et al. A differential cytokine expression profile is induced by highly purified human menopausal gonadotropin and recombinant follicle-stimulating hormone in a pre- and postovulatory mouse follicle culture model. Fertil Steril. 2010;93:1464-76.
  24. Skrzypczak J, Wirstlein P, Mikolajczyk M. Could the defects in the endometrial extracellular matrix during the implantation be a cause of impaired fertility? Am J Reprod Immunol 2007;57:40-8.
  25. Salmassi AG, Schaefer S, Koch K, Hedderich J, Jonat W, et al. Is granulocyte colony-stimulating factor level predictive for human IVF outcome? Hum Reprod 2005;20:2434-40.
  26. T. Adriaenssens, R. White, P. Riviere, R. Cortvrindt, J. Arce, J. Smitz. Differential gene expression patterns in cumulus cells from in vitro grown follicles exposed to FSH alone or to FSH and LH-activity. Fertil Steril 2006 ;86 (10-11Suppl).
  27. Munoz M, Cruz M, Humaidan P, Garrido N, Perez-Cano I, Meseguer M. Dose of recombinant FSH and oestrodiol concentrationon day of HCG affect embryo developement kinetics. RBM Online, 2012 ;25:382-9.
  28. Meseguer, M., Herrero, J., Tejera, A., Hilligsoe, K.M., Ramsing, N.,Remohi, J. The use of morphokinetics as a predictor of embryo implantation. Hum. Reprod.2011;26:2658-71.
  29. Manno, M., Cervi, M., Zadro, D., Fuggetta, G., Adamo, V., Tomei, F. Different ART outcomes at increasing peak estradiol levels with long and antagonist protocols: retrospective insights from ten years experience. J. Assist. Reprod. Genet.2011; 28:693-8.
  30. Papageorgiou, T., Guibert, J., Goffinet, F., Patrat, C., Fulla, Y., Janssens, Y., Zorn, J.R. Percentile curves of serum estradiol levels during controlled ovarian stimulation in 905 cycles stimulated with recombinant FSH show that high estradiol is not detrimental to IVF outcome. Hum. Reprod 2002;17:2846-50.
  31. J.Smitz, A.N.Andersen, P.Devroey and J.-C.Arce for the MERIT Group. Endocrine profile in serum and follicular fluid differs after ovarian stimulation with HP-hMG or recombinant FSH in IVF patients. Hum Reprod 2007;22: 676-87.
  32. Requena A, Cruz M, Ruiz FJ, García-Velasco JA. Endocrine profile following stimulation with recombinant follicle stimulating hormone and luteinizing hormone versus highly purified human menopausal gonadotropin. Reprod Biol Endocrinol 2014;12:10.
  33. Sebag-Peyrelevade S, El Hachem H, Gallot V, Genro VK, Fanchin R. The influence of exogenous LH/hCG activity on serumprogesterone levels on the day of hCG administrationin in vitro fertilization. J Gynecol Obstet Biol Reprod. 2015; 44:524-31.
  34. Bosch E, Labarta E, Crespo J, Simon C, Remohi J, Jenkins J, et al. Circulating progesterone levels and ongoing pregnancy rates in controlled ovarian stimulation cycles for in vitro fertilization: analysis of over 4000 cycles. Hum Reprod 2010; 25: 2092-100.
  35. Ochsenkühn R, Arzberger A, von Schönfeldt V, Gallwas J, Rogenhofer N, Crispin A et al, Subtle progesterone rise on the day of human chorionic gonadotropin administration is associated with lower live birth rates in women undergoing assisted reproductive technology: a retrospective study with 2,555 fresh embryo transfers. Fertil Steril 2012;98:347-54.
  36. Weissman A, Gotileb L, Casper RF. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril 1999;71:147-9.
  37. Richter KS, Bugge KR, Bromer JG, Levy MJ. Relationship between endometrial thickness and embryo implantation, based on 1294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril 2007; 87:53-9.
  38. Sifer C, Cédrin-Durnerin I, Hugues JN, Poncelet C. Views of each member of an Assisted Reproductive Technologies centre on the embryo transfer procedure. Gynecol Obstet Fertil 2009;37:645-52.
  39. Platteau P, Andersen AN, Balen A, Devroey P, Sørensen P, Helmgaard L et al for the Menopur Ovulation Induction (MOI) Study Group. Similar ovulation rates, but different follicular development with highly purified menotrophin compared with recombinant FSH in WHO Group II anovulatory infertility: a randomized controlled study. Hum Reprod 2006;21:1798-804.
  40. Fanchin R, Righini C, Olivennes F, Taieb J, De Ziegler D and Frydman R. Computerized assessment of endometrial echogenicity: clues to the endometrial effects of premature progesterone elevation. Fertil Steril 1999;71:174-81.
  41. Fanchin R, Righini C, Ayoubi J-M, Olivennes F, de Ziegler D and Frydman R. New look at endometrial echogenicity: objective computer-assisted measurements predict endometrial receptivity in in vitro fertilizationembryo transfer. Fertil Steril 2000;74:274-81.
  42. VanWely M, Kwan I, Burt AL, Thomas J, Vail A, Van der Veen F, Al-Inany HG. Recombinant versus urinary gonadotrophin for ovarian stimulation in assisted reproductive technology cycles. Cochrane Database of Syst Rev 2011, Issue 2. Art. No.: CD005354. DOI: 10.1002/14651858.CD005354.pub2
  43. Jaro Wex-Wechowski, Ahmed M Abou-Setta, Sandy Kildegaard Nielsen, Richard Kennedy. HP-HMG versus rFSH in treatments combining fresh and frozen IVF cycles: success rates and economic evaluation. RBM Online 2010; 21:166-78.
  44. Mark Connolly, Kathleen De Vrieze, Willem Ombelet, Dirk Schneider, Craig Currie. A cost per live birth comparison of HMG and rFSH randomized trials. RBM Online 2008;17:756-63.
  45. J. de Mouzon, E. Allavena, C. Schmitt, M. Frappé. In vitro fertilization in France: economic aspects and influence of the gonadotropin choice (urinary vs. recombinant) on cost. Gynecol Obstet Fertil 2004;32:508-18.
  46. Al Inany H, Aboulghar MA, Mansour RT, Serour GI ; Ovulation Induction in the New Mellenium: Recombinant FSH Vs hMG. Gynecol Endocrinol.2005;20:161-9.
  47. Stokman PG, de Leeuw R, van den Wijngaard HA, Kloosterboer HJ, Vemer HM, Sanders AL. Human chorionic gonadotropin in commercial human menopausal gonadotropin preparations. Fertil Steril 1993;60:175-8.
  48. Van de Weijer BH, Mulders JW, Bos ES, Verhaert PD, van den Hooven HW. Compositional analyses of a human menopausal gonadotrophin preparation extracted from urine (menotropin). Identification of some of its major impurities. RBM Online 2003;7:547 - 57.