4.3 Article

Comparing pregnancy rates following ovarian stimulation with follitropin-? to follitropin -? in routine IVF: A retrospective analysis

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DOI: 10.1016/j.ejogrb.2022.11.006

Keywords

Follitropin; Gonadotropin dose; Optimal ovarian response; Ongoing pregnancy rate; Cumulative ongoing pregnancy rate

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This study compares the clinical outcomes of using a new recombinant follicle stimulation hormone, Follitropin-Delta, with Follitropin-alpha in routine IVF procedures. The results show that there were no significant differences in ovarian response, fertilization rate, embryo quality, and clinical pregnancy rate between the two groups. Furthermore, there were similar outcomes between patients who would have qualified and those who would have been disqualified based on previous randomized controlled trial inclusion criteria.
Study objectives: Follitropin-Delta, a new recombinant follicle stimulation hormone, uses a fixed daily dose producing a predictable ovarian response while using less gonadotropins compared to follitropin-alpha. We report clinical outcomes comparing each in the routine IVF setting and further compare qualified to disqualified subjects based on previous randomized controlled trial (RCT) inclusion criteria.Study design: Retrospective analysis of all cycles performed by a single provider between January 2020 to January 2021. All IVF cycles without patient inclusion-exclusion criteria were considered for the analysis. Clinical outcomes in two groups (follitropin-Delta vs follitropin-alpha +/- 75 IU human menopausal gonadotropin (hMG) in expected poor responders) were compared. In addition, comparisons were made between qualified versus disqualified subgroups.Results: No differences in baseline demographics, number of MII oocytes, fertilization/MII oocyte, percent of good quality embryos were noted. Compared to those using follitropin-alpha, follitropin-Delta resulted in lower daily (170 vs 211 IU/d, p = 0.002) and total Gn used (1739 vs 2194 IU, p = 0.003). Optimal range response (8-14 oocytes) (22/44 [50 %] vs 78/203 [38.6 %]; p = 0.10) and fresh (fCP) and cumulative clinical pregnancy (cCP) rates per transfer (29.5 % vs 24.1 % and 35 % vs 25.1 %, p = 0.08) were similar between groups. Based on previous RCTs, those who would have qualified compared to those who would have disqualified, patients using follitropin-Delta were just as likely to have an optimal oocyte response (qualified: 48 % vs disqualified: 57.1 %) and resulted in similar cCP (41.4 % vs 25 %, p-0.23).Conclusions: While follitropin-Delta requires less daily and total dosing compared to follitropin-alpha, optimal range of retrieved oocytes and clinical outcomes appear to be comparable. Using RCT inclusion criteria, similar findings were noted in those who would have qualified compared to disqualified patients.

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