Comparison of recombinant and urinary follicle-stimulating hormones over 2000 gonadotropin-releasing hormone antagonist cycles: a retrospective study

Wei Pan,Jianwu Xiong,Yuehan Li,Wulin Pan,Weiming Huang,Renjie Wang,Dongyang Yu,Haiting Tu,Shujie Liao,Cheng Hu,Lei Jin

doi:10.1038/s41598-019-41846-2

Abstract

The objective of this paper was to compare the effect of recombinant follicle-stimulating hormone (rFSH) and urinary follicle-stimulating hormone (uFSH) on pregnancy rates and live birth rates with the gonadotropin-releasing hormone (GnRH) antagonist protocol in China. This retrospective study was conducted from January 2014 through August 2017. Patients treated with uFSH had significantly higher levels of luteinizing hormone (3.79 mIU/ml vs. 3.09 mIU/ml) and progesterone (0.93 ng/ml vs. 1.16 ng/ml) on the day of human chorionic gonadotropin (HCG) administration, and they also had higher pregnancy rates (24.19% vs. 22.86%). There was no significant difference in the rate of live births. In the logistic regression results of the rFSH group, the pregnancy rate was positively correlated with the level of luteinizing hormone, with an odds ratio (OR) of 1.09 (95% confidence interval [CI]: 1.00–1.18; P = 0.048). In the uFSH group, the pregnancy rate was negatively correlated with the progesterone level on the day of HCG administration, with an OR of 0.47 (95% CI: 0.27–0.77; P = 0.004). Our research concluded that uFSH performed better than rFSH in terms of pregnancy rates when it was associated with the GnRH antagonist protocol. Meanwhile, no significant differences in the rate of live births were observed between the two groups.

Highlights

One in six couples worldwide will experience at least one infertility problem during their reproductive years[1], and the majority will benefit from assisted reproductive technology (ART)
When associated with the gonadotropin-releasing hormone (GnRH) antagonist protocol, our research revealed that urinary follicle-stimulating hormone (uFSH) was better than recombinant follicle-stimulating hormone (rFSH) in terms of pregnancy rates
Our results support the conclusion of Youssef et al They analysed 394 cycles with GnRH agonists, revealing that gonadotropin affects clinical pregnancy rate (CPR) in ART cycles[11]

Summary

Introduction

One in six couples worldwide will experience at least one infertility problem during their reproductive years[1], and the majority will benefit from assisted reproductive technology (ART). Papers have rarely compared the effect of recombinant follicle-stimulating hormone (rFSH) and urinary follicle-stimulating hormone (uFSH) on pregnancy rates and live birth rates with the GnRH antagonist protocol in a retrospective study. Many studies have compared uFSH with rFSH with the GnRH agonist protocol regarding numbers of oocytes, pregnancy rates, live birth rates, and so on. These studies suggested that rFSH had an inferior performance in older patients than uFSH with a lower dose of FSH, but no evidence has shown that rFSH has clinical advantages for CPRs of different urinary-derived FSH gonadotropins when used with the GnRH antagonist protocol[12,13]. By evaluating a large number of variables in common patients and selecting significant correlation variables for logistic regression model analysis, the results can be used to assess what factors determine the success of ART in general and when applied to the general population

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