Individualization of the starting dose of follitropin delta reduces the overall OHSS risk and/or the need for additional preventive interventions: cumulative data over three stimulation cycles

Sánchez, Manuel Fernández; Višňová, Hana; Yuzpe, A. Albert; Klein, Bjarke M.; Mannaerts, Bernadette; Arce, Joan‐Carles

doi:10.1016/j.rbmo.2018.12.032

Cited by 39 publications

(40 citation statements)

References 24 publications

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“…After a secondary analysis of ESTHER-1, Fernández-Sánchez et al confirmed that individualized dosing with follitropin δ significantly reduced moderate/severe OHSS and/or the need of OHSS preventive interventions in patients undergoing up to three COS cycles, and the greatest benefit was observed in patients in the highest AMH quartile, those with the maximal risk of severe OHSS [ 43 ].…”

Section: Recombinant Human Fsh (R-hfsh)mentioning

confidence: 99%

Human Recombinant FSH and Its Biosimilars: Clinical Efficacy, Safety, and Cost-Effectiveness in Controlled Ovarian Stimulation for In Vitro Fertilization

et al. 2020

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Exogenous human follicle-stimulating hormone (hFSH), either derived from extraction and purification from the urine or obtained by recombinant technology in the form of follitropin α, β and δ (rFSH), has been used for decades in the treatment of infertility. The main applications of FSH treatment in the woman have been, and still are, ovulation induction in oligo-anovulatory subjects, and stimulation of the development of a cohort of follicles in patients undergoing controlled ovarian stimulation (COS) for in vitro fertilization (IVF). In the last years, two biosimilars of follitropin alfa, rFSH compounds structurally and functionally similar to the originator, have been approved and marketed for clinical use in Europe. Moreover, some other rFSH biosimilars are currently under investigation. The objective of this article is to review the available evidences comparing the efficacy, safety, and cost-effectiveness of rFSH follitropin alpha originator with its biosimilars, discussing the clinical trials that allowed biosimilars to get registration and marketing authorization.

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Section: Recombinant Human Fsh (R-hfsh)mentioning

confidence: 99%

Human Recombinant FSH and Its Biosimilars: Clinical Efficacy, Safety, and Cost-Effectiveness in Controlled Ovarian Stimulation for In Vitro Fertilization

et al. 2020

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“…Addition of hp-hMG on day of antagonist initiation significantly lowers OHSS rates [8]. In sequential ovarian stimulation cycles, individualized doses of follitropin delta decreased the risk of moderate/severe OHSS than conventional follitropin alfa regimen [9].…”

Section: Introductionmentioning

confidence: 99%

Follicular Aspiration Is Superior to Coasting as Effective Prophylactic Procedure against Ovarian Hyperstimulation Syndrome

Elnagar¹,

Ebian²

2019

OJOG

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Objectives: Evaluation of outcome follicular aspiration compared to coating procedure for infertile women undergoing ICSI regarding frequency and severity of ovarian hyperstimulation syndrome (OHSS). Patients & Methods: Infertile PCOS women underwent controlled ovarian stimulation with luteal phase GnRH-agonist long down-regulation protocol. Women developed serum E 2 level > 4000 pg/ml and/or >20 follicles of ≥10 mm in diameter were randomly divided to receive coasting strategy (Coasting group) or TVU-guided aspiration (Aspiration group). When ≥3 follicles were ≥18 mm and serum E 2 level was <3000 pg/ml, GnRH agonist was continued, and 10,000 IU was administered 36 h before oocyte retrieval, and ICSI was performed 72-hr thereafter and the frequency of moderate-to-severe OHSS was determined. Results: 82 women developed criteria for categorization and 21 women (25.6%) developed moderate-to-severe OHSS; 5 women of aspiration and 16 of Coasting group; with significantly (P = 0.005) lower frequency in aspiration group. Twenty women developed ascites; 3 women had clinically detectable, while 17 women had US detected ascites with significantly (P = 0.039) higher frequency among women that had coasting. All other manifestations of OHSS were significantly lower with aspiration procedure. Both coasting and aspiration therapy significantly reduced serum E2 and ovarian diameter on day of hCG injection compared to estimates taken at time of categorization. Conclusion: Coasting procedure prior to hCG injection could decrease incidence of OHSS and lessens its manifestation. Follicular aspiration provided more superior results and improved outcome of these women. Any of these modalities could be provided to infertile high-risk women according to the availability of experiences and patients' selection. How to cite this paper: Elnagar, W.M. and Ebian, H.F.

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Section: Introductionmentioning

confidence: 99%

“…OHSS is an iatrogenic complication of ovarian stimulation that is potentially life threatening [8]. A challenge for fertility specialists is prevention and finding a balance between ovarian stimulation for a successful outcome and reducing the patient's risk of OHSS [8,11]. As a result, certain characteristics and diagnostic markers of a patient's ovarian reserve, namely AMH, are used to identify the patients at risk of developing OHSS and individualize the starting dose of gonadotropin [8,15].…”

Section: Introductionmentioning

confidence: 99%

“…A challenge for fertility specialists is prevention and finding a balance between ovarian stimulation for a successful outcome and reducing the patient's risk of OHSS [8,11]. As a result, certain characteristics and diagnostic markers of a patient's ovarian reserve, namely AMH, are used to identify the patients at risk of developing OHSS and individualize the starting dose of gonadotropin [8,15]. However, with conventional highly purified urinary gonadotropins or with recombinant follicle stimulating hormone (FSH or follitropin) alpha, clinicians must make an educated guess as to a starting dose that will produce an optimal number of oocytes while reducing the risk of OHSS.…”

Section: Introductionmentioning

confidence: 99%

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Low risk of OHSS with follitropin delta use in women with different polycystic ovary syndrome phenotypes: a retrospective case series

2021

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Background To explore the efficacy of follitropin delta in ovarian stimulation of patients with the Rotterdam ESHRE/ASRM 2003 phenotypes of polycystic ovarian syndrome (PCOS) using a retrospective case series with an electronic file search in a reproductive medicine clinic. Case presentation Seventy-four patients with PCOS undergoing ovarian stimulation according to the individualized dosing algorithm of follitropin delta for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI)/oocyte freezing were included. Follitropin delta resulted in a high number of pre-ovulatory follicles at the end of stimulation as expected in patients with PCOS. There was a large number of oocytes retrieved with an acceptable percentage of metaphase II (MII) oocytes. There were no cases of moderate or severe OHSS across all phenotypes. Conclusion Follitropin delta, using the individualized dosing algorithm, appears to be a safe method of ovarian stimulation with a low risk of OHSS in PCOS patients without sacrificing successful stimulation outcomes.

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Individualization of the starting dose of follitropin delta reduces the overall OHSS risk and/or the need for additional preventive interventions: cumulative data over three stimulation cycles

Abstract: In total, 37 sites from 11 countries (see Appendix) participated in ESTHER-1 and 32 of the 37 sites participated in ESTHER-2.

Cited by 39 publications

References 24 publications

Human Recombinant FSH and Its Biosimilars: Clinical Efficacy, Safety, and Cost-Effectiveness in Controlled Ovarian Stimulation for In Vitro Fertilization

Human Recombinant FSH and Its Biosimilars: Clinical Efficacy, Safety, and Cost-Effectiveness in Controlled Ovarian Stimulation for In Vitro Fertilization

Follicular Aspiration Is Superior to Coasting as Effective Prophylactic Procedure against Ovarian Hyperstimulation Syndrome

Low risk of OHSS with follitropin delta use in women with different polycystic ovary syndrome phenotypes: a retrospective case series

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