Register for Highly purified menotrophins are as effective as recombinant treatments for IVF
InfertilityAugust 8, 2002
2002 AUG 8 - (NewsRx.com & NewsRx.net) -- A wealth of evidence confirms that there is no difference in pregnancy rates when comparing highly purified menotrophin (hMG) with recombinant FSH (rFSH), yet significant differences exist in cost.
This information is particularly relevant as health authorities are increasingly requiring that physicians practice evidence-based medicine as well cost effectiveness.
During the annual meeting of the European Society of Human Reproduction & Embryology, researchers will present numerous studies in support of the use of human-derived products and away from the more expensive recombinant treatments because of equality in efficacy.
Vinay Sharma of the Reproductive Medicine Unit at St. James's Hospital in Leeds, U.K., made a comparison of urinary and recombinant gonadotrophins after an audit of 8 years of her clinical practice, found that patients receiving hMG had a significantly higher probability of achieving a clinical pregnancy per cycle.
She also found that hMG patients were 2.02 and uFSH were 1.80 times more likely to have live birth compared with rFSH in fresh IVF cycles and clinical pregnancy rate in ICSI cycles was significantly higher in hMG and uFSH compared with rFSH.
"This is the first time where the clinical practice of a single program in consecutive cycles has shown a significant difference in live birth rates per cycle," said Sharma. "Especially when patients have made the choice with regards to the type of gonadotrophin based on cost, effectiveness and route of administration."
Marco Filicori, of the Reproductive Endocrinology Center at the University of Bologna, Italy presented data from two comparative studies between highly purified hMG and rFSH. His presentation highlighted the role and importance of LH in ovarian stimulation protocols and the conflicting data surrounding this area.
His findings show that when carefully matched experimental conditions were applied, human-derived gonadotropins appeared to be equally effective as rFSH to achieve successful COS and pregnancy, both in IUI and ICSI.
Indeed, there were no indications of untoward effects associated with LH activity administration, such as the occurrence of premature luteinization or increased miscarriage.
"This evidence confirms that highly purified menotrophin is at least as effective as rFSH, providing a balanced, natural source of LH and FSH in ovarian stimulation protocols," said Filicori.
LH (luteinizing hormone) encourages the development of less small follicles, which are associated with ovarian hyperstimulation syndrome (OHSS). Furthermore, LH is essential in IVF/ICSI protocols using down regulation. A lack of LH has been linked to poor oocyte maturity, embryo development, and implantation rates. In order to minimize risk to pregnancy outcome it would seem more convenient to ensure both FSH and LH are provided at sufficient levels. This article was prepared by Women's Health Weekly editors from staff and other reports.
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