Comparison of highly purified FSH (Metrodin-High Purity) with Pergonal for IVF superovulation

Bagratee, Jayanthilall; Lockwood, Gillian; Bernal, Andrés López; Barlow, David H.; Ledger, William

doi:10.1007/bf02766827

Cited by 10 publications

(4 citation statements)

References 12 publications

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“…Moreover, the mere content of menopausal urine-richer in FSH than LH-led to a relative excess production of FSH, thereby pushing the pharmaceutical industry to develop FSH-only preparations. As discussed below, various clinical trials comparing urinary-derived FSH and hMG globally led to similar results (17), although E 2 levels on the day of ovulation triggering were slightly lower in the FSH group (18).…”

Section: The Path Toward Recombinant Gonadotropinsmentioning

confidence: 75%

Rooted in pre-assisted reproductive technology times menotropins are still used today: a narrative review of literature

et al. 2021

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Human menopausal gonadotropins (hMGs) had been developed long before the advent of assisted reproductive technology (ART) for the induction of ovulation in women suffering from hypogonadotropic hypogonadism. The advent of ART offered a new application for hMGs, for inducing multiple follicular ovarian stimulation (OS) in generally normally ovulating women. The advent of follicle-stimulating hormone (FSH) preparations obtained by genetic recombination techniques in the early 1990s, recombinant FSH, was originally seen as an imminent death knell for hMG preparations obtained from menopausal urine. Yet, 25 years later, hMG preparations-now in a highly purified form-are still part of our treatment options for OS in ART.Over the years, meta-analyses have generally shown a similar or slight advantage in terms of ART outcomes (implantation, ongoing pregnancy, and live birth rates) for hMG preparations, albeit small in magnitude. Yet, recently, mounting evidence has indicated that certain women whose endogenous luteinizing hormone (LH) levels are low, who are older, and/or who are prone to hyper-respond to OS are likely to benefit from receiving hMGs for OS. Today, hMG preparations gain their LH bioactivity from human chorionic gonadotropin obtained from a pituitary or chorionic source, with higher numbers of matured metaphase-II oocytes obtained in the latter case.

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Section: The Path Toward Recombinant Gonadotropinsmentioning

confidence: 75%

Rooted in pre-assisted reproductive technology times menotropins are still used today: a narrative review of literature

et al. 2021

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“…Blood estrogen assays are advocated to check the ovarian response, in case HCG need be withheld to avoid OHSS. HMG and uFSH are similarly effective in this type of regime (Westergaard et al, 1996;Bagratee et al, 1998).…”

Section: Programmed Stimulation Cyclesmentioning

confidence: 93%

IVF endocrinology: the Edwards era

Hillier

2013

Molecular Human Reproduction

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Through pioneering human IVF as a global infertility treatment, Robert Edwards and his clinical partner Patrick Steptoe launched the field of IVF endocrinology. Following repeated failures with oocytes collected in human menopausal gonadotrophin (HMG) primed cycles timed to injection of human chorionic gonadotrophin (HCG), the first successful IVF pregnancy came from a spontaneous menstrual cycle. Intensive endocrine monitoring was used to track pre-ovulatory follicular development and collect a single ripe egg timed to the natural LH surge. Despite this groundbreaking achievement, ovulation induction was clearly required to make IVF treatment clinically robust and reliable. Ovarian stimulation with clomiphene citrate was used to achieve the first maternity from a superovulated human IVF cycle in 1980. HMG/HCG regimens were then successfully introduced-including substitution of 'pure' follicle-stimulating hormone as the principal ovarian stimulant. The application and success of IVF treatment were dramatically enhanced by the introduction of gonadotrophin-releasing hormone analogues that enabled elective control of endogenous gonadotrophin release during ovarian stimulation. Programmed gonadotrophin regimes yielding double-digit oocyte numbers became normal: 'more is better' was the ethos. Bob Edwards expressed increasing concern over the cost, complexity and potential long-term health risks of such high-order ovarian stimulation. In later life he repeatedly called for a return to minimalist approaches based on the natural menstrual cycle to improve oocyte quality over quantity. This article reviews the application of ovulation induction to human IVF and celebrates Edwards' abiding impact on the field, which firmly grounds him in the reproductive endocrinology pantheon.

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“…With the long GnRHa down-regulation protocol well established globally, the need for LH activity supplementation during ovarian stimulation was explored and questioned. Urinary FSH preparations were introduced and reported to be equal, or even better, than the old HMG products [2][3][4][5]. These and similar publications added scientific justification to the decision of the Pharma industry to introduce recombinant FSH products only, claiming that LH was not needed in the context of GnRHa down-regulation and ovarian stimulation, although physiology tells us that LH and FSH work in synergy, playing complementary roles during follicle development and ovulation.…”

Section: Which Gonadotropin Formulation To Use In the Long Gnrha Down...mentioning

confidence: 99%

Luteinizing Hormone and Ovarian Stimulation for In-Vitro Fertilization: Do Science and Business Always Agree?

Kol¹,

Humaıdan²

2022

CEI

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The current commentary paper follows the historical introduction of gonadotropins and gonadotropin releasing hormone (GnRH) analogues to the in-vitro fertilization (IVF) market. We maintain that business decisions significantly influenced research and development; however, pharma decisions did not always align with physiology and clinical interests. Specifically, the never-ending debate on the issue of luteinizing hormone (LH) supplementation during ovarian stimulation was repeatedly studied using population-based randomized controlled trials. However, LH activity supplementation is an endocrine issue and therefore, specific endocrine inclusion/exclusion criteria should be used when assessing the needs or not for LH in our “every-day” patients. We propose that the approach until now has defocused the research question and thus, also the debate and that there is a need to revisit physiology and clinical thinking if the LH supplementation issue is to be unravelled.

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Comparison of highly purified FSH (Metrodin-High Purity) with Pergonal for IVF superovulation

Cited by 10 publications

References 12 publications

Rooted in pre-assisted reproductive technology times menotropins are still used today: a narrative review of literature

Rooted in pre-assisted reproductive technology times menotropins are still used today: a narrative review of literature

IVF endocrinology: the Edwards era

Luteinizing Hormone and Ovarian Stimulation for In-Vitro Fertilization: Do Science and Business Always Agree?

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