Follicle-Stimulating Hormone: A Review of Form and Function in the Treatment of Infertility

Smitz, Johan; Wolfenson, Claudio; Chappel, Scott C.; Ruman, Jane

doi:10.1177/1933719115607992

Cited by 38 publications

(13 citation statements)

References 62 publications

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“…There has been much discussion on the presumed differences in biopotency of the various gonadotrophins related to isoform composition and acidity. Some studies describe that it is unknown whether these differences influence biopotency (Practice Committee of American Society for Reproductive Medicine, Birmingham, Alabama, 2008; Smitz et al ., 2016), while others suggest that in view of the higher biopotency in vitro, rFSH might also be more biopotent in vivo ( Barrios-De-Tomasi et al ., 2002; Andersen et al ., 2004; Andersen and Ezcurra, 2011 ) , and one study suggests that, because of the longer plasma half-lives, more acid isoforms have an higher in vivo bioactivity (Wolfenson et al ., 2005).…”

Section: Discussionmentioning

confidence: 99%

Required amount of rFSH, HP-hMG and HP-FSH to reach a live birth: a systematic review and meta-analysis

Mol

Veen

Wely

2019

Human Reproduction Open

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STUDY QUESTION In women undergoing IVF or ICSI cycles, do recombinant gonadotrophins differ from urinary-derived highly purified human menopausal gonadotropin (HP-hMG) or highly purified follicle-stimulating hormone (HP-FSH) in the total amount of gonadotrophins required to reach a live birth? SUMMARY ANSWER The difference between recombinant and urinary-derived HP-hMG or HP-FSH in the required amount to reach a live birth in IVF/ICSI cycles appears small. WHAT IS KNOWN ALREADY At present, gynecologists can choose between recombinant FSH (rFSH), urinary-derived HP-hMG and HP-FSH. These products are equally effective and safe, but it is unknown how these gonadotrophins compare in terms of IU required to reach a live birth. STUDY DESIGN, SIZE AND DURATION We conducted a search in Medline, Embase and CINAHL up to July 2018. We included randomized controlled trials (RCTs) that compared rFSH with HP-hMG or HP-FSH for ovarian stimulation in couples scheduled for IVF or ICSI treatment. From each randomized trial, we extracted the outcome data and information on participants, methods, interventions and funding. PARTICIPANTS/MATERIALS, SETTING AND METHODS Women undergoing ovarian stimulation with rFSH, HP-hMG or HP-FSH were included. We extracted data for the mean amount of gonadotrophins with SD, clinical pregnancy rate, live birth rate and cumulative live birth rate per woman from the included RCTs. We summarized these outcomes by calculating the individual and pooled mean difference (MD) or relative risk (RR) with 95% CI. We used the Review Manager software to perform the meta-analyses. We applied a random effect model to pool the data. We estimated the total amount of gonadotrophins used per extra live birth by STATA 14.2 and R software. MAIN RESULTS AND THE ROLE OF CHANCE A total of 28 studies with 7553 women were included in this review, of which 24 studies provided information on the total amount of gonadotrophins per woman who started an IVF/ICSI cycle. The total amount of gonadotrophins varied significantly between studies. The MDs in total amount were −37 IU (seven studies; N = 3220; 95% CI, −115 to 41; I 2 = 68%) for rFSH versus HP-hMG and −31 IU (17 studies; N = 3629; 95% CI, −290 to 228; I 2 = 97%) for rFSH versus HP-FSH. For rFSH versus HP-hMG, the RR for clinical pregnancy, live birth and cumulative live birth were 0.90 (95% CI, 0.81–1.00), 0.88 (95% CI, 0.78–0.99) and 0.91 (95% CI, 0.80–1.04), respectively. For rFSH versus HP-FSH, the RR for clinical pregnancy and live birth were 1.03 (95% CI, 0.94–1.13) and 1.03 (95% CI, 0.90–1.18), respectively; the data on cumulative live birth rate were lacking. The estimated difference in mean gonadotrophin amount per extra live birth was 789 IU (95% CI, ...

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Section: Discussionmentioning

confidence: 99%

Required amount of rFSH, HP-hMG and HP-FSH to reach a live birth: a systematic review and meta-analysis

Mol

Veen

Wely

2019

Human Reproduction Open

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“…The actions of FSH in regulating the reproductive axis have been extensively investigated through years (Howles 2000; Loraine and Schmidt-Elmendorff 1963; Sairam and Krishnamurthy 2001; Simoni, et al 1999; Smitz, et al 2016; Zafeiriou, et al 2000). FSH binds and activates, a 7 transmembrane (7TMR) domain containing FSH receptor (FSHR) expressed in granulosa cells in ovaries and Sertoli cells in testes (Simoni, et al 1997).…”

Section: Regulation Of Fsh Actionmentioning

confidence: 99%

Molecular regulation of follicle-stimulating hormone synthesis, secretion and action

Das

Kumar

2018

Journal of Molecular Endocrinology

116

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“…For multi-follicular growth, high amounts of exogenous FSH are administered daily to achieve the FSH threshold (14,15). Currently, recombinant FSH (rFSH) is the most widely used (16,17), and it has shown bioavailability after single administration of 63-66% (18,19). Additionally, it will reach the steady state after 5-7 days of repeated administration (20).…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Serum Delta FSH Level and Ovarian Response in IVF/ICSI Cycles

Sun

et al. 2020

Front. Endocrinol.

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Background: When ovarian response to FSH stimulation for IVF/ICSI is unsatisfactory, the FSH dose is often adjusted in the treatment cycles, thereby assuming that hormone status and follicular development were insufficient for optimal stimulation. Objectives: To evaluate whether serum delta FSH levels between D6 of gonadotrophin use and basal serum FSH or between D6 of gonadotrophin use and D1 of gonadotrophin use predict ovarian response in IVF/ICSI cycles. Method: The participants of this retrospective study were chosen from the Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University between August 2015 and December 2017 (n = 3,109), and during the COS, each participant was given a fixed dose of rFSH in the first 6 days. Delta FSH1: The difference of serum FSH between D6 of gonadotrophin use and basal serum FSH. Delta FSH2: The difference of serum FSH between D6 of gonadotrophin use and D1 of gonadotrophin use. Logistic regression was used to analyze the association between delta FSH1 level and delta FSH2 level and ovarian response. Besides, we also use the tertile statistics to divide the groups. Results: Part I: Delta FSH1 levels (mean: 1.41 ± 3.46) in normal responders were higher than delta FSH1 levels (mean: 1.07 ± 23.89) in hyper responders (P = 0.0248). The tertile of delta FSH1 is dif ≤ 0, 0 < dif ≤ 2.25 and dif > 2.25. Compared with the hyper responder, the delta FSH1 (0 < dif ≤ 2.25 and dif > 2.25) in the normal responder has a higher ratio and is statistically significant. Part II: Delta FSH2 levels (mean: 4.90 ± 2.84) in normal responders were similar with delta FSH2 levels (mean: 4.74 ± 2.09) in hyper responders (P = 0.103). The tertile of delta FSH1 is dif ≤ 3.91, 3.91 < dif ≤ 5.69 and dif > 5.69. Compared with the hyper responders, the delta FSH2 (3.91 < dif ≤ 5.69 and dif > 5.69) in the normal responders has a higher ratio and is statistically significant. Conclusions: There is a weak relationship between ovarian response and serum delta FSH levels.

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Follicle-Stimulating Hormone: A Review of Form and Function in the Treatment of Infertility

Cited by 38 publications

References 62 publications

Required amount of rFSH, HP-hMG and HP-FSH to reach a live birth: a systematic review and meta-analysis

Required amount of rFSH, HP-hMG and HP-FSH to reach a live birth: a systematic review and meta-analysis

Molecular regulation of follicle-stimulating hormone synthesis, secretion and action

The Relationship Between Serum Delta FSH Level and Ovarian Response in IVF/ICSI Cycles

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