The efficiency of using menotropins in the general patient population in the ivf protocols in the Northwestern Region of Russia
- Authors: Gerkulov D.A.1, Kalugina A.S.2,1
-
Affiliations:
- Skyfert Clinic of Reproduction
- I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia
- Issue: No 2 (2023)
- Pages: 134-139
- Section: Exchange of Experience
- URL: https://journals.eco-vector.com/0300-9092/article/view/340784
- DOI: https://doi.org/10.18565/aig.2023.23
- ID: 340784
Cite item
Open Access
Access granted
Abstract
Objective: To evaluate the clinical efficiency and safety of using highly purified human menopausal gonadotropins (HP hMG) in the IVF protocols in existing clinical practice in the protocols with GnRH agonists and antagonists in the Northwestern Region of Russia.
Materials and methods: A multicenter open-label observational study was conducted in 13 centers in the Northwestern Region of Russia. During 3 years from 2017 to 2020, the study enrolled 1504 patients aged 20 to 43 years who were treated for infertility by assisted reproductive technologies (IVF).
Results: There were high clinical pregnancy rates per started cycle (50.0%), high live birth rate per embryo transfer (43.1%), with a low transfer cancellation rate (5.4%), including an extremely low risk for ovarian hyperstimulation syndrome (1.4%).
Conclusion: Taking into account the high efficacy and safety, the authors can recommend the use of HP hMG as first-line drugs of choice in the general population when stimulating superovulation in the IVF protocols.
Full Text
About the authors
Dmitry A. Gerkulov
Skyfert Clinic of Reproduction
Author for correspondence.
Email: gerkulov@gmail.com
PhD
Russian Federation, Saint PetersburgAlla S. Kalugina
I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia; Skyfert Clinic of Reproduction
Email: gerkulov@gmail.com
Dr. Med. Sci., Professor, Department of Obstetrics, Gynecology and Neonatology; obstetrician-gynecologist, reproductologist, General Director
Russian Federation, Saint Petersburg; Saint PetersburgReferences
- La Marca A., Sunkara S.K. Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum. Reprod. Update. 2014; 20(1): 124-40. https://dx.doi.org/10.1093/humupd/dmt037.
- Kalugina A.A., Boyarsky K.Yu., Makolkin A.A., Zvereva I.O., Voznesenskaya Yu.V., Kholodov D.V. Review of the results of clinical studies of follitropin delta in ovarian stimulation protocols. The first experience of its use in Russia. Obstetrics and Gynecology. 2021; (11): 246-64. (in Russian). https://dx.doi.org/10.18565/aig.2021.11.246-264.
- Devroey P., Pellicer A., Andersen A.N., Arce J.-C.; Menopur in GnRH antagonist cycles with single embryo transfer trial group. A randomized assessor-blind trial comparing highly purified hMG and recombinant FSH in a GnRH antagonist cycle with compulsory single-blastocyst transfer. Fertil. Steril. 2012; 97(3): 561-71. https://dx.doi.org/10.1016/j.fertnstert.2011.12.016.
- Arce J.C., Klein B.M., La Marca A. The rate of high ovarian response in women identified at risk by a high serum AMH level is influenced by the type of gonadotropin. Gynecol. Endocrinol. 2014; 30(6): 444-50. https://dx.doi.org/ 10.3109/09513590.2014.892066.
- Makarova N.P., Lobanova N.N., Kulakova E.V., Nepsha O.S., Ekimov A.N., Kalinina E.A. Impact of preimplantation genetic testing on assisted reproductive technology outcomes in couples with male factor infertility. Obstetrics and Gynecology. 2021; (11): 154-64. (in Russian). https://dx.doi.org/10.18565/aig.2021.11.154-164.
- Cornelisse S., Zagers M., Kostova E., Fleischer K., van Wely M., Mastenbroek S. Preimplantation genetic testing for aneuploidies (abnormal number of chromosomes) in in vitro fertilisation. Cochrane Database Syst. Rev. 2020; 9(9): CD005291. https://dx.doi.org/10.1002/14651858.CD005291.pub3.
- Ye H., Huang G., Pei L., Zeng P., Luo X. Outcome of in vitro fertilization following stimulation with highly purified hMG or recombinant FSH in downregulated women of advanced reproductive age: a prospective, randomized and controlled trial. Gynecol. Endocrinol. 2012; 28(7): 540-4. https://dx.doi.org/10.3109/09513590.2011.650742.
- European and Israeli Study Group on Highly Purified Menotropin Versus Recombinant Follicle-Stimulating Hormone. Efficacy and safety of highly purified menotropin versus recombinant follicle stimulating hormone in vitro fertilization/intracytoplasmic sperm injection cycles: a randomized, comparative trial. Fertil Steril. 2002; 78(3): 520-8. https://dx.doi.org/10.1016/s0015-0282(02)03250-8.
- Alfarawati S., Fragouli E., Colls P., Stevens J., Gutiérrez-Mateo C., Schoolcraft W.B. et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil. Steril. 2011; 95(2): 520-4. https://dx.doi.org/10.1016/j.fertnstert.2010.04.003.
- Witz C.A., Daftary G.S., Doody K.J., Park J.K., Seifu Y., Yankov V.I., Heiser P.W.; Menopur in GnRH Antagonist Cycles with Single Embryo Transfer – High Responder (MEGASET-HR) Trial Group. Randomized, assessor-blinded trial comparing highly purified human menotropin and recombinant follicle-stimulating hormone in high responders undergoing intracytoplasmic sperm injection. Fertil. Steril. 2020; 114(2): 321-30. https://dx.doi.org/10.1016/ j.fertnstert.2020.03.029.
- Smitz J., Andersen A.N., Devroey P., Arce J.C.; MERIT Group. Endocrine profile in serum and follicular fluid differs after ovarian stimulation with HP-hMG or recombinant FSH in IVF patients. Hum. Reprod. 2007; 22(3): 676-87. https://dx.doi.org/10.1093/humrep/del445.
- Arce J.C., Smitz J. Live-birth rates after HP-hMG stimulation in the long GnRH agonist protocol: association with mid-follicular hCG and progesterone concentrations, but not with LH concentrations. Gynecol. Endocrinol. 2013; 29(1): 46-50. https://dx.doi.org/10.3109/09513590.2012.705379.
- Bosch E., Labarta E., Crespo J., Simón C., Remohí J., Jenkins J., Pellicer A. Circulating progesterone levels and ongoing pregnancy rates in controlled ovarian stimulation cycles for in vitro fertilization: analysis of over 4000 cycles. Hum. Reprod. 2010; 25(8): 2092-100. https://dx.doi.org/10.1093/humrep/deq125.
- Labarta E., Martínez-Conejero J.A., Alamá P., Horcajadas J.A., Pellicer A., Simón C., Bosch E. Endometrial receptivity is affected in women with high circulating progesterone levels at the end of the follicular phase: a functional genomics analysis. Hum. Reprod. 2011; 26(7): 1813-25. https://dx.doi.org/10.1093/humrep/der126.
- Andersen A.N., Devroey P., Arce J.C. Clinical outcome following stimulation with highly purified hMG or recombinant FSH in patients undergoing IVF: a randomized assessor-blind controlled trial. Hum. Reprod. 2006; 21(12): 3217-27. https://dx.doi.org/10.1093/humrep/del284.
Supplementary files
