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Reproductive Biomedicine
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Volume 15, Issue 7 (8-2017)
IJRM 2017, 15(7): 435-440 |
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Shahrokh Tehraninejad E, Farshbaf Taghinejad M, Hossein Rashidi B, Haghollahi F. Controlled ovarian stimulation with r-FSH plus r-LH vs. HMG plus r-FSH in patients candidate for IVF/ICSI cycles: An RCT. IJRM 2017; 15 (7) :435-440
URL: http://ijrm.ir/article-1-840-en.html
URL: http://ijrm.ir/article-1-840-en.html
Ensieh Shahrokh Tehraninejad1 
, Mina Farshbaf Taghinejad * 2, Batool Hossein Rashidi1 , Fedyeh Haghollahi1
, Mina Farshbaf Taghinejad * 2, Batool Hossein Rashidi1 , Fedyeh Haghollahi1
1- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
2- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran ,mina.farshbaft@gmail.com
2- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran ,
Abstract: (4686 Views)
Background: Different combination of gonadotropin preparation has been introduced with no definite superiority of one over others in in vitro fertilization (IVF), but individualized regimens for each patient are needed.
Objective: The aim of the present study was to investigate the effect of controlled ovarian stimulation with recombinant- follicle stimulating hormone (r-FSH) plus recombinant-luteinizing hormone (rLH) versus human menopausal gonadotropin (HMG) plus r-FSH on fertility outcomes in IVF patients.
Materials and Methods: This is a randomized clinical trial study that was performed from October 2014-April 2016 on 140 infertile patients with a set of inclusion criteria that referred to infertility clinics in Vali- asr and Gandhi Hospital in Tehran. The women were randomly divided into two treatment groups. The first group (n=70) received rFSH from the second day of cycle and was added HMG in 6th day and the 2nd group (n=70), received rFSH from the second day of cycle and was added recombinant-LH in 6th day. Then ovum Pick-Up and embryo transfer were performed. In this study, we assessed the outcomes such as; chemical and clinical pregnancy rate, live birth and abortion rate.
Results: Number of follicles in ovaries, total number of oocytes or M2 oocytes and quality of fetuses has no significant differences between two groups (p>0.05). Total number of fetuses were significantly higher in patients who received rFSH + HMG (p=0.02). Fertility outcomes consisted of: live birth rate, chemical pregnancy and clinical pregnancy rate were higher in rFSH + HMG group in comparison to rFSH +r-LH group (p<0.05).
Conclusion: It seems that in IVF patients, HMG + rFSH used for controlled ovarian hyperstimulation have better effects on fertility outcomes, but in order to verify the results, it is recommended to implement studies on more patients.
Objective: The aim of the present study was to investigate the effect of controlled ovarian stimulation with recombinant- follicle stimulating hormone (r-FSH) plus recombinant-luteinizing hormone (rLH) versus human menopausal gonadotropin (HMG) plus r-FSH on fertility outcomes in IVF patients.
Materials and Methods: This is a randomized clinical trial study that was performed from October 2014-April 2016 on 140 infertile patients with a set of inclusion criteria that referred to infertility clinics in Vali- asr and Gandhi Hospital in Tehran. The women were randomly divided into two treatment groups. The first group (n=70) received rFSH from the second day of cycle and was added HMG in 6th day and the 2nd group (n=70), received rFSH from the second day of cycle and was added recombinant-LH in 6th day. Then ovum Pick-Up and embryo transfer were performed. In this study, we assessed the outcomes such as; chemical and clinical pregnancy rate, live birth and abortion rate.
Results: Number of follicles in ovaries, total number of oocytes or M2 oocytes and quality of fetuses has no significant differences between two groups (p>0.05). Total number of fetuses were significantly higher in patients who received rFSH + HMG (p=0.02). Fertility outcomes consisted of: live birth rate, chemical pregnancy and clinical pregnancy rate were higher in rFSH + HMG group in comparison to rFSH +r-LH group (p<0.05).
Conclusion: It seems that in IVF patients, HMG + rFSH used for controlled ovarian hyperstimulation have better effects on fertility outcomes, but in order to verify the results, it is recommended to implement studies on more patients.
Keywords: Ovulation induction, Recombinant-FSH, Recombinant-LH, Human menopausal gonadotropin, IVF, ICSI
Type of Study: Original Article |
References
1. Bosch E, Ezcurra D. Individualised controlled ovarian stimulation (iCOS): maximising success rates for assisted reproductive technology atients. Reprod Biol Endocrinol 2011; 21: 82. [DOI:10.1186/1477-7827-9-82]
2. Revelli A, Pettinau G, Basso G, Carosso A, Ferrero A, Dallan C, et al. Controlled Ovarian Stimulation with recombinant-FSH plus recombinant-LH vs. human MenopausalGonadotropin based on the number of retrieved oocytes: results from a routine clinical practice in a real-life population. Reprod Biol Endocrinol 2015; 13: 77. [DOI:10.1186/s12958-015-0080-6]
3. Filicori M, Fazleabas AT, Huhtaniemi I, Licht P, Rao ChV, Tesarik J, et al. Novel concepts of human chorionic gonadotropin: reproductive system interactions and potential in the management of infertility. Fertil Steril 2005; 84: 275-284. [DOI:10.1016/j.fertnstert.2005.02.033]
4. Platteau P, Andersen AN, Balen A, Devroey P, Sørensen P, Helmgaard L, et al. Menopur Ovulation Induction (MOI) Study Group. Similar ovulation rates, butdifferent follicular development with highly purified menotrophin compared withrecombinant FSH in WHO Group II anovulatory infertility: a randomized controlled study. Hum Reprod 2006; 21: 1798-1804. [DOI:10.1093/humrep/del085]
5. Pacchiarotti A, Sbracia M, Frega A, Selman H, Rinaldi L, Pacchiarotti A.Urinary hMG (Meropur) versus recombinant FSH plus recombinant LH(pergoveris) in IVF: a multicenter, prospective, randomized controlled trial. Fertil Steril 2010; 94: 2467-2469. [DOI:10.1016/j.fertnstert.2010.04.035]
6. Hill MJ, Levy G, Levens ED. Does exogenous LH in ovarian stimulation improve assisted reproduction success? An appraisal of the literature. Reprod Biomed Online 2012; 24: 261-271. [DOI:10.1016/j.rbmo.2011.12.005]
7. Alviggi C, Clarizia R, Mollo A, Ranieri A, De Placido G. Outlook: who needs LH in ovarian stimulation? Reprod Biomed Online 2006; 12: 599-607. [DOI:10.1016/S1472-6483(10)61186-8]
8. Maguire M, Csokmay J, Segars J, Payson M, Armstrong A. Enough is enough!Patients who do not conceive on 600 IU/d of gonadotropins show no improvement from an additional 150 IU of LH activity. Fertil Steril 2011; 95: 372-373. [DOI:10.1016/j.fertnstert.2010.08.020]
9. Revelli A, Chiado' A, Guidetti D, Bongioanni F, Rovei V, Gennarelli G. Outcome of in vitro fertilization in patients with proven poor ovarian responsiveness after early vs. mid-follicular LH exposure: a prospective, randomized, controlled study. J Assist Reprod Genet 2012; 29: 869-875. [DOI:10.1007/s10815-012-9804-0]
10. Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, Behre HM et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010; 16: 231-245. [DOI:10.1093/humupd/dmp048]
11. Heitmann RJ, Hill MJ, Richter KS, DeCherney AH, Widra EA. The simplified SART embryo scoring system is highly correlated to implantation and live birth in single blastocyst transfers. J Assist Reprod Genet 2013; 30: 563-567. [DOI:10.1007/s10815-013-9932-1]
12. Balasch J, Miro F, Burzaco I, Casamitjana R, Civico S, Ballesca JL, et al. The role ofluteinizing hormone in human follicle development and oocyte fertility:evidence from IVF in a woman with long-standing hypogonadism and usung recombinant human follicle stimulating hormone. Hum Reprod 1995; 10: 1678-1683. [DOI:10.1093/oxfordjournals.humrep.a136154]
13. Tesarik J, Mendoza C. Effects of exogenous LH administration during ovarian stimulation of pituitary down-regulated young oocyte donors on oo-cyte yield and developmental competence. Hum Reprod 2002; 17: 3129-3137. [DOI:10.1093/humrep/17.12.3129]
14. Fleming R, Chung CC, Yates RW, Coutts JR. Purified urinary follicle stimulating hormone induces different hormone profiles compared to menotrophins, dependent upon the route of administration and endogenous luteinizing hormone activity. Hum Reprod 1996; 11: 1854-18588. [DOI:10.1093/oxfordjournals.humrep.a019506]
15. De Placido G, Mollo A, Alviggi C, Strina I,Varricchio MT, Ranieri A, et al. Rescue of IVF cycles by HMG in pituitary down-regulated normo-gonadotrophic young women characterized by a poor initial response to recombinant FSH. Hum Reprod 2001; 16: 1875-1879. [DOI:10.1093/humrep/16.9.1875]
16. Westergaard LG, Laursen SB, Yding Andersen C.Increased risk of early pregnancy loss by profound suppression of luteinizing hormone during ovarian stimulation in normogonadotrophic women undergoing assisted reproduction. Hum Reprod 2000; 15: 1003-10088. [DOI:10.1093/humrep/15.5.1003]
17. 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. [DOI:10.1186/1477-7827-12-10]
18. Wolfenson C, Groisman J, Couto AS, Hedenfalk M, Cortvrindt RG, Smitz JE,et al. Batch-to-batch consistency of human-derived gonadotrophin preparations compared with recombinant preparations. Reprod Biomed Online 2005; 10: 442-454. [DOI:10.1016/S1472-6483(10)60819-X]
19. Gadkari RA, Roy S, Rekha N, Srinivasan N, Dighe RR. Identification of a heterodimer-specific epitope present in human chorionic gonadotrophin (hCG) using a monoclonal antibody that can distinguish between hCG and human LH. J Mol Endocrinol 2005; 34: 879-887. [DOI:10.1677/jme.1.01683]
20. Casarini L, Lispi M, Longobardi S, Milosa F, La Marca A, Tagliasacchi D, et al. LH and hCG action on the same receptor results in quantitatively and qualitatively different intracellular signalling. PLoS One 2012; 7: e46682. [DOI:10.1371/journal.pone.0046682]
21. Fábregues F, Creus M, Casals G, Carmona F, Balasch J. Outcome from consecutive ICSI cycles in patients treated with recombinant human LH and those supplemented with urinary hCG-based LH activity during controlled ovarian stimulation in the long GnRH-agonist protocol. Gynecol Endocrinol 2013; 29: 430-4355. [DOI:10.3109/09513590.2012.754873]
22. 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 sys-tematic review and meta-analysis. Hum Reprod 2008; 23: 310-315. [DOI:10.1093/humrep/dem305]
23. Bühler KF, Fischer R. Recombinant human LH supplementation versus supplementation with urinary hCG-based LH activity during controlled ovarian stimulation in the long GnRH-agonist protocol: a matched case-control study. Gynecol Endocrinol 2012; 28: 345-350. [DOI:10.3109/09513590.2011.633128]
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