Open AccessComparison of FSH and hMG on ovarian stimulation outcome with a GnRH antagonist protocol in younger and advanced reproductive age women
Author(s) -
Tabata Chisa,
Fujiwara Toshihiro,
Sugawa Miki,
Noma Momo,
Onoue Hiroki,
Kusumi Maki,
Watanabe Noriko,
Kurosawa Takako,
Tsutsumi Osamu
Publication year - 2015
Publication title -
reproductive medicine and biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.005
H-Index - 22
eISSN - 1447-0578
pISSN - 1445-5781
DOI - 10.1007/s12522-014-0186-0
Subject(s) - gonadotropin , in vitro fertilisation , medicine , follicle stimulating hormone , hmg coa reductase , gonadotropin releasing hormone antagonist , endocrinology , follicular phase , hormone , andrology , antagonist , ovarian reserve , gonadotropin releasing hormone , menotropins , embryo , biology , ovulation induction , ovulation , infertility , luteinizing hormone , pregnancy , receptor , biochemistry , enzyme , reductase , microbiology and biotechnology , genetics
Purpose To compare the embryo outcomes of in vitro fertilization/intra‐cytoplasmic sperm injection with a gonadotropin‐releasing hormone (GnRH) antagonist protocol with follicle stimulating hormone (FSH) and with human menopausal gonadotropin (hMG). Methods We performed a retrospective cohort study in 465 patients. Stimulation was started by daily FSH injection, and either FSH was continued (FSH alone group) or hMG was administrated (FSH‐hMG group) after administration of a GnRH antagonist. Primary outcomes were the embryo profile (number of retrieved, mature, and fertilized eggs, and morphologically good embryos on day 3) and endocrine profile. Secondary outcomes were the doses and durations of gonadotropin. Data were stratified by the patients’ age into two groups: <35 years and ≥35 years. Results In patients aged <35 years, the number of retrieved oocytes in the FSH alone group was significantly increased than that in the FSH‐hMG group (13.7 vs 9.2, P = 0.04), while there was no difference at other age groups. The FSH‐hMG group required a significantly greater amount of gonadotropins at any age (all ages, P < 0.001; <35 years, P = 0.013; ≥35 years, P < 0.001). Conclusions Exogenous FSH alone is probably sufficient for follicular development and hMG may not improve the embryo profile in a GnRH antagonist protocol across all age.