A randomized comparative study of purified follicle stimulating hormone and human menopausal gonadotropin after pituitary desensitization with Buserelin  for superovulation and in vitro fertilization

Bentick, Bernard; Shaw, Robert W.; Iffland, C.A.; Burford, G. D.; Bernard, A

doi:10.1016/s0015-0282(16)60012-2

Cited by 41 publications

(5 citation statements)

References 16 publications

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“…The non-statistically significant difference in clinical pregnancy rate between the two gonadotrophin preparations matched other reported trials in the medical literature [4,7].…”

Section: Discussionsupporting

confidence: 83%

A Prospective Comparative Study on IVF Outcomes with Either Purified FSH or Human Menopausal Gonadotrophin in Downregulated Normogonadotrophic Women

Ismail

Hesham²,

Salah³

et al. 2002

Gynecol Obstet Invest

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Objective: In compare the use of purified follicle-stimulating hormone with that of a preparation containing follicle-stimulating hormone and luteinizing hormone in infertile females undergoing IVF. Design: Open-labelled prospective controlled single-center study. Setting: Nile Badrawy IVF unit. Participants: 153 infertile females undergoing their first cycle of IVF divided into 2 groups. Interventions: Ovarian stimulation was done with either highly purified FSH for group 1 (n = 75) or human menopausal gonadotrophin group 2 (n = 78) after pituitary desensitization commenced in the midluteal phase of the preceding cycle. Monitoring was performed by ultrasound transvaginal oocyte retrieval followed by IVF and transfer of three embryos. Outcomes: Number of oocytes >18 mm at day of hCG, fertilization rate, embryo transfer rate, clinical pregnancy rate and incidence of ovarian hyperstimulation syndrome. Results: The response to ovarian hyperstimulation was similar in both groups. The number of follicles >18 mm achieved at day of hCG was 12.3 ± 0.9 (mean ± SEM) following stimulation with 38.3 ± 0.9 ampoules of Fostimon The Menogon-treated group needed 39.1 ± 0.8 ampoules to produce 11.6 ± 0.7 follicles. Fertilization rate (2PN/cell) was 58.6 vs. 64.2% in the Fostimon and Menogon group, respectively (p > 0.05). The number of embryos transferred per woman was 3.1 ± 0.1 in the Fostimon group and 3.6 ± 0.1 in the Menogon group. The pregnancy rate per woman was 33.3 vs. 25.6% in the Fostimon- and Menogon-treated groups, respectively (p > 0.05). Miscarriage rate was 16 vs 20%, respectively. However, the incidence of multiple pregnancies was significantly higher in the Fostimon-treated group (32%) vs. 10% only in the Menogon-treated group (p < 0.01). Conclusion: Purified FSH yields similar clinical outcome to hMG in terms of oocytes retrieved and clinical pregnancies in a standard IVF regimen.

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“…The non-statistically significant difference in clinical pregnancy rate between the two gonadotrophin preparations matched other reported trials in the medical literature [4,7].…”

Section: Discussionsupporting

confidence: 83%

A Prospective Comparative Study on IVF Outcomes with Either Purified FSH or Human Menopausal Gonadotrophin in Downregulated Normogonadotrophic Women

Ismail

Hesham²,

Salah³

et al. 2002

Gynecol Obstet Invest

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“…Many studies used the long agonist stimulation protocol for IVF (Porter et al, 1984;Wildt et al, 1986;Awadalla et al, 1987;De Ziegler et al, 1987;Macnamee et al, 1987;Neveu et al, 1987;Sharma et al, 1987;Arnal et al, 1988;BelaischAllart et al, 1988;Bentick et al, 1988;Fenichel et al, 1988;Foulot et al, 1988;Frydman et al, 1988a;Hedon et al, 1988;Rutherford et al, 1988;Zorn et al, 1988) and some used the short regimen (Barriere et al, 1987;Loumaye et al, 1988;Palermo et al, 1988;Vauthier et al, 1989). We selected six comparative studies using the long agonist stimulation protocol for IVF.…”

Section: Discussionmentioning

confidence: 99%

“…In brief, there have only been a few random studies (Neveu et al, 1987;Bentick et al, 1988). All authors showed a reduction in the failure rate of stimulation cycles and a greater number of collected oocytes and of embryos obtained in vitro with GnRH agonist protocols.…”

Section: Discussionmentioning

confidence: 99%

“…The use of GnRH agonists increases the number of oocytes retrieved, the number of embryos obtained in vitro, the implantation rate of these embryos and finally the pregnancy rate (Awaldalla etal., 1987;Barriere etal 1987;Howies etal, 1987;Sharma et al, 1987;Arnal et al, 1988;Belaisch-Allart et al, 1988;Bentick et al, 1988;Fenichel et al, 1988;Frydman etal, 1988b;Loumaye et al, 1988;Rutherford et al, 1988;MacLachlan et al, 1989). But the cost of GnRH agonist protocols depends on the type of protocol (ultra short, short or long), on the type and dosage of agonist and gonadotrophins (HMG) that are being used and on the duration of the monitoring phase before 138 the human chorionic gonadotrophin (HCG) injection.…”

Section: Introductionmentioning

confidence: 99%

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Early or late monitoring of stimulation of ovulation for in-vitro fertilization? A methodological discussion of a randomized study

et al. 1990

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Two GnRH agonist long-stimulation protocols, in association with HMG, are compared on a random basis. Group A (n = 53) was monitored daily from the 6th day of stimulation, whereas monitoring in group B (n = 55) began on the 11th day of stimulation. There was no significant difference in the numbers of follicles which matured, the numbers of collected oocytes, the numbers of embryos obtained in vitro and the clinical pregnancy rate. But the power of such a study is very weak (6%). It would have been necessary to include greater than 1000 patients in each group to obtain a bioequivalence test. Such a study is unrealistic for a single centre and multicentric studies are very difficult to achieve because of practical difficulties. A pooled analysis is perhaps the methodological answer.

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“…Follicular phase administration of LHRH agonist has the disadvantage of rescue of the old corpus luteum, showing the capacity of luteal tissue to respond to a luteotrophic stimulus after its expected life-span (Fleming et al, 1987). For this reason, LHRH agonist administration commencing in the luteal phase of the cycle has been used to suppress pituitary function prior to induction of ovulation (Bentick et al, 1988;Matson et al, 1988).…”

Section: Introductionmentioning

confidence: 99%

Endocrine changes in women conceiving during treatment with an LHRH agonist

Isherwood¹,

Ibrahim²,

Matson³

et al. 1990

Human Reproduction

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We report on eight patients who conceived during pituitary desensitization with buserelin in the luteal phase of the menstrual cycle. Pregnancy was diagnosed between day 12 and 21 of buserelin administration. Analysis of serum luteinizing hormone on day 12 showed that pituitary desensitization occurred in conjunction with increasing production of ovarian steroid hormones. Serum concentrations of human chorionic gonadotrophin (HCG) were less than 10 IU/l on day 1 of buserelin administration for seven of the eight patients. The serum concentration of HCG on day 12 showed a median value of 722 IU/l (range 14.6-798 IU/l). Five of the eight patients were given HCG support (10,000 IU) following the diagnosis of pregnancy--three of these patients have ongoing pregnancies and the remaining two had blighted ova on scan. Of the remaining three patients, one had a singleton pregnancy which miscarried at 9 weeks, one had a blighted ovum on scan and bled per vagina shortly after this, and one bled per vagina prior to a scan being carried out. Our results show that pregnancy can occur during pituitary desensitization with buserelin, despite patients being counselled not to have unprotected intercourse in the cycle during which administration commences. An HCG assay on day 1 of buserelin administration is not helpful. Pregnancy should be suspected when ovarian steroid production persists despite complete pituitary down-regulation.

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A randomized comparative study of purified follicle stimulating hormone and human menopausal gonadotropin after pituitary desensitization with Buserelin for superovulation and in vitro fertilization

Cited by 41 publications

References 16 publications

A Prospective Comparative Study on IVF Outcomes with Either Purified FSH or Human Menopausal Gonadotrophin in Downregulated Normogonadotrophic Women

A Prospective Comparative Study on IVF Outcomes with Either Purified FSH or Human Menopausal Gonadotrophin in Downregulated Normogonadotrophic Women

Early or late monitoring of stimulation of ovulation for in-vitro fertilization? A methodological discussion of a randomized study

Endocrine changes in women conceiving during treatment with an LHRH agonist

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