Highly purified-hMG versus rFSH in ovarian hyperstimulation in women undergoing elective fertility preservation

In women undergoing elective fertility preservation, rFSH appears to yield more oocytes than hp-hMG, but the implications of these findings should be interpreted with caution due to potential confounding factors.

Summary and findings

This study compared the effects of highly purified human menopausal gonadotropin (hp-hMG) and recombinant FSH (rFSH) on ovarian response in 456 women undergoing elective fertility preservation. The findings indicated that rFSH resulted in a higher number of retrieved and mature oocytes compared to hp-hMG. No therapeutic claims are made.

Abstract

<title>Abstract</title> <p><bold>Purpose:</bold> To compare recombinant FSH (rFSH) with highly purified-human menopausal gonadotrophin (hp-hMG) on ovarian response in women undergoing elective fertility preservation (FP). <bold>Methods:</bold> This retrospective study included 456 women who underwent elective FP with gonadotropin-releasing hormone (GnRH) antagonist or progestin-primed ovarian stimulation (PPOS) protocols between 01/2017-12/2021. Three-hundred and forty-one women were stimulated with rFSH and 115 with hp-hMG, and the ovarian stimulation outcomes were compared between the two groups. A multivariate linear regression analysis assessed the impact of age, basal FSH level, antral follicle count, and protocol type on the ovarian stimulation outcomes. <bold>Results: </bold>Women in the rFSH group were significantly younger, and their antral follicle count was significantly higher than those in the hp-hMG group (35.50±2.12 vs. 35.99±2.13 years,<italic> P </italic>= 0.034 and 13.76±6.08 vs. 11.84±6.06, <italic>P</italic> = 0.002). There were no significant group differences in the amount (<italic>P</italic> = 0.645) and duration (<italic>P</italic> = 0.265) of FSH stimulation. The peak estradiol level was significantly lower for the rFSH group compared to the hp-hMG group (2547.18±1648.21 pg/mL vs. 3468.02±2497.69 pg/mL, <italic>P</italic> < 0.001), while peak progesterone level was significantly higher (1.33±0.75 ng/mL vs. 1.01±0.52 ng/mL, <italic>P</italic> = 0.001). The numbers of retrieved and MII oocytes were significantly higher for the rFSH group compared with the hp-hMG group (16.82±10.95 vs. 13.25±9.66, <italic>P</italic> = 0.02, and 13.22±9.13 vs. 9.76±7.11, <italic>P</italic> = 0.005), while the maturity rates were comparable (<italic>P</italic> = 0.103). <bold>Conclusion:</bold> rFSH was demonstrated to have superior oocyte yield compared to hp-hMG in ovarian hyperstimulation for women undergoing elective FP.</p>

Elsewhere in the HMG (Human Menopausal Gonadotropin) corpus