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Related Experiment Videos

FSH: urinary and recombinant.

A Palagiano1, E Nesti, L Pace

  • 1Il University of Naples, Department of Obstetrics, Gynecology and Reproductive Sciences, Largo Madonna delle Grazie, 1-80183, Napoli, Italy. antonio@palagiano.org

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|June 16, 2004
PubMed
Summary

Recombinant follicle-stimulating hormone (r-FSH) is more effective than urinary FSH (u-FSH) for ovulation induction in assisted reproductive techniques (ART). Though r-FSH has a higher cost, it leads to more oocytes, better embryo quality, and increased pregnancies.

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Area of Science:

  • Reproductive Endocrinology
  • Biotechnology
  • Clinical Trials

Background:

  • Infertility affects 10-15% of couples, with assisted reproductive techniques (ART) like IVF and ICSI aiding conception.
  • Controlled ovarian hyperstimulation (COH) utilizes drugs such as GnRH agonists/antagonists and FSH or HMG for ovulation induction.
  • Follicle-stimulating hormone (FSH) is crucial for ovulation induction; recombinant FSH (r-FSH) offers advantages over urinary FSH (u-FSH) due to purity and safety.

Purpose of the Study:

  • To compare the efficacy of recombinant FSH (r-FSH) and urinary FSH (u-FSH) for ovulation induction in ART through a review of randomized studies.
  • To evaluate the effectiveness of different FSH preparations in achieving successful pregnancies and high-quality embryos.

Main Methods:

  • Systematic review and meta-analysis of published randomized controlled trials comparing r-FSH and u-FSH for ovulation induction in ART.

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  • Analysis of data focusing on oocyte retrieval, embryo quality, pregnancy rates, and cost-effectiveness.

    • Main Results:

    • No single study had sufficient power to detect significant differences in pregnancy rates between r-FSH and u-FSH.
    • Meta-analyses indicate r-FSH use is preferable, yielding more oocytes, improved embryo quality, and higher pregnancy rates.
    • Cost-effectiveness analyses confirm r-FSH as the most effective therapy for ovulation induction in ART, considering ongoing pregnancies.

    Conclusions:

    • While direct comparisons lack statistical power for pregnancy rates, meta-analyses favor r-FSH for ART due to superior oocyte yield and embryo quality.
    • r-FSH demonstrates higher effectiveness in ovulation induction for ART, justifying its use despite a higher initial cost.
    • r-FSH is the most effective ovulation induction therapy in ART, supported by cost-effectiveness studies and improved clinical outcomes.