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Recombinant versus urinary gonadotrophins for triggering ovulation in assisted conception
Hesham Al-Inany1, Mohamed A Aboulghar, Ragaa T Mansour
1The Egyptian IVF-ET Center, Maadi, Cairo, Egypt. kaainh@link.net
Human Reproduction (Oxford, England)
|July 19, 2005
Summary
This systematic review found no significant difference in pregnancy success rates between recombinant and urinary gonadotrophins for final oocyte maturation. Recombinant HCG showed fewer local site reactions, suggesting safety and cost should guide gonadotrophin choice.
Area of Science:
- Reproductive Endocrinology
- Pharmacology
- Clinical Trials
Background:
- Assessing the safety and efficacy of recombinant (r) HCG and high-dose rLH versus intramuscular urinary (u) uHCG.
- Focus on inducing final oocyte maturation and triggering ovulation in fertility treatments.
Purpose of the Study:
- To systematically review and compare the clinical outcomes of recombinant versus urinary gonadotrophins.
- Evaluate safety and efficacy in assisted reproductive technologies.
Main Methods:
- Systematic review of randomized controlled trials (RCTs).
- Searched multiple databases (Cochrane, MEDLINE, EMBASE) up to February 2004.
- Independent data extraction and quality assessment by at least two reviewers.
Main Results:
- Seven RCTs identified: four comparing rHCG vs. uHCG, three comparing rhLH vs. uHCG.
- No statistically significant difference in ongoing pregnancy/live birth rates between rHCG and uHCG, or rhLH and uHCG.
- Recombinant HCG (rHCG) showed a significant reduction in local site reactions compared to uHCG.
Conclusions:
- No evidence of clinical outcome differences between urinary and recombinant gonadotrophins for final follicular maturation.
- Safety, cost, and drug availability are key factors in gonadotrophin selection.
- Further research may be warranted to explore nuanced differences in safety profiles.