Abstract
The use of corifollitropin alfa (CA) in assisted reproductive technology (ART) cycles is dependent on the antral follicle count and body weight of patients. The present study investigated the safety and efficacy of using 100μg of CA in predicted excessive responders based on serum anti-Mullerian hormone (AMH) level. The results of 381 ART cycles stimulated by CA versus daily recombinant follicle-stimulation hormone (rFSH) in patients with low (<1.0 ng/mL; n = 38 vs. n = 90), moderate (1.0–3.36 ng/mL; n = 38 vs. n = 95), and high (> 3.36 ng/mL; n = 48 vs. n = 72) serum AMH levels, were analyzed. Pregnancy and live birth rates did not significantly differ between CA and daily rFSH groups. In the patients with high AMH levels, serum progesterone (P4) levels on the day of human chorionic gonadotropin (hCG) injection were significantly lower in the CA group than in the rFSH group (0.93 ± 0.55 vs. 1.16 ± 0.64 ng/mL). Furthermore, serum P4 levels on the day of hCG injection were negatively correlated with baseline AMH levels in the CA group, but not in the rFSH group, in the patients with high AMH levels. In conclusion, the use of 100 μg of CA in patients with high AMH levels is safe and effective and is associated with a lower P4 level on the day of hCG injection compared with the use of daily rFSH.
Highlights
Corifollitropin alfa (CA), a novel recombinant molecule exhibiting long-acting follicle stimulating hormone (FSH) bioactivity, was recently developed for clinical use in assisted reproductive technology (ART) cycles
The results of the present study suggested that the serum anti-Mullerian hormone (AMH) levels affected follicular development and P4 production in the patients with high basal AMH levels receiving CA treatment
High baseline AMH levels were associated with low P4 levels on the day of human chorionic gonadotropin (hCG) injection in the CA but not in the daily recombinant FSH (rFSH) protocol
Summary
Corifollitropin alfa (CA), a novel recombinant molecule exhibiting long-acting follicle stimulating hormone (FSH) bioactivity, was recently developed for clinical use in assisted reproductive technology (ART) cycles. One injection of CA can replace seven injections of daily recombinant FSH (rFSH) used for controlled ovarian stimulation in ART cycles [1]. Several randomized clinical trials including Engage [2], Ensure [3], and Pursue [4] have compared the safety and efficacy of CA with those of daily rFSH in a gonadotropin releasing hormone (GnRH) antagonist protocol used in ART cycles for normal or poor responders. The use of CA is based on the antral follicle count (AFC) and body weight of patients. Some clinical modifications in ART treatment were performed in the Engage trial without affecting the pregnancy outcome [6], information regarding predicted excessive responders is lacking
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