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Recombinant FSH vs. urinary FsH for ovarian stimulation in in vitro fertilization
Meden-Vrtovec, Helena ...
Objective: To compare ovarian stimulation with recombinant FSH (rFSH) vs. urinary FSH (uFSH) in terms of hormonal events within ovarian follicles and the outcome of in vitro fertilization. STUDY ...DESIGN: A prospective randomized comparative study of rFSH (n = 70) vs. uFSH (n = 61) ovarian stimulation. Hormone determinations were serum estradiol (E2) on the day of human chorionicgonadotropin (hCG) administration, and E2, androstenedione (A) and testosterone (T) at the time of follicular aspiration in the follicular fluid and serum. Results: The total dose of gonadotropins required and the length ofovarian stimulation were the same in the 2 groups. In follicular fluid the E2 and the A levels were significantly higher in the rFSHgroup (3,065+- 1,646 vs. 2,368 +- 1,240 nmol/L, P = .004, and 103.7 51.6 vs. 89.0 42.3 nmol/L, P = .042, respectively), whereas A: E2 and T:E2 ratios were significantly lower (39.6+-22.5 vs. 52.3 +- 59.6, P = .042, and 9.1 +- 4. 7 vs. 17.6 +- 26.9, P = .006, respectively). Serum hormonal levels, number of oocytes retrieved and pregnancy rates did not differ significantly between the groups. Conclusion: rFSH provides results similar to those of uFSH. rFSH enhances steroidogenesis and provokes different androgen/estrogen ratios than does uFSH without influencing the outcome of in votro fertilization.
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