Corifollitropin alfa compared with follitropin beta in poor responders undergoing ICSI: a randomized controlled trial

Abstract

Corifollitropin alfa simplifies IVF treatment because it is administered in a GnRH antagonist protocol and replaces seven daily FSH injections with a single one of a long acting FSH without compromising the outcome. It could greatly reduce the burden of treatment for poor responders and this deserves further investigation.

Mild Versus Conventional Ovarian Stimulation for Poor Responders Undergoing IVF/ICSI

“…The sample size was estimated based on the number of COCs retrieved. In this context, and based on previous study designs (16,20), we agreed on a difference of two COCs retrieved between the two groups with a standard deviation of 2.5. By using two-sided t-test, with 80% power, 25 patients in each group would be required, assuming a significance level of 0.05.…”

“…In contrast, positive β-hCG, clinical pregnancy and live birth rates were low, but similar for both groups studied, as was the miscarriage rate, which appeared to be increased in both regimes. These results might possibly be attributed to the otherwise anticipated low pregnancy rates in this category of patients with compromised ovarian response (16,27,28), added to the observation that a higher dose of gonadotropin does lead to improved implantation rates (29). Regarding clinical pregnancy rates, our findings are in agreement with the existing trials (19)(20)(21); notably, a difference of 8%, favoring the conventional protocol did not manage to reach statistical significance, as one would expect the higher number of COCs to result in such a difference.…”

“…By assuming the number of COCs anticipated in OR in comparison to the conventional approach, our primary outcome shifted from live birth, a parameter that adds to the significance of the results of the study when considering clinical practice. By reporting live birth as a primary outcome, a large number of participants would be required (≥200) and this could solely be achieved in a multicenter setting, as stated in a recent trial (16). Another limitation might be the existence of two conventional protocols, representing the control group.…”

“…The reduced yield of oocytes is inevitably interlinked with lowered success rates, especially for this group of patients, where the anticipated quality of the gametes is also reduced (1,2,(14)(15)(16). Clomiphene citrate is one of the main adjuncts (together with letrozole) used in mild regimes for the ovarian stimulation of poor responders, the definition of whom varies widely.…”

Corifollitropin alfa. Efficacy, safety and convenience for doctor and patient

“…В отношении эффективности применения корифолли-тропина альфа среди пациентов с ожидаемым бедным ответом E.M. Kolibianakis et al [32] было проведено ран-домизированное исследование. В нем приняли участие 79 пациенток с бедным ответом в анамнезе в возрасте до 45 лет и ИМТ от 18 до 32 кг/м 2 .…”