Influence of ovarian stimulation with HP-hMG or recombinant FSH on embryo quality parameters in patients undergoing IVF
Authors: Ziebe, Sren; Lundin, Kersti; Janssens, Ronny; Helmgaard, Lisbeth; Arce, Joan-Carles
Source: Human Reproduction, Volume 22, Number 9, 18 September 2007 , pp. 2404-2413(10)
Publisher: Oxford University Press
There are limited data on the impact of different gonadotrophin preparations on embryo quality.
This evaluation was part of a randomized, assessor-blind, multinational trial, conducted in 731 women undergoing IVF after stimulation with highly purified human menopausal gonadotropin (HP-hMG; MENOPUR) (n 363) or recombinant FSH (rFSH; GONAL-F) (n 368). Ongoing pregnancy was the primary end-point [HP-hMG 27 and rFSH 22; odds ratio (OR) (95 confidence interval, CI) 1.25 (0.89-1.75)]. All 7535 oocytes retrieved were evaluated daily until day 3 (embryo transfer) in a blinded manner both by local site embryologists and a central panel of three embryologists.
The proportion of top-quality embryos per oocyte retrieved was higher with HP-hMG (11.3) compared with rFSH (9.0) (P 0.044) in the local assessment, but comparable in the central assessment (9.5 and 8.0, respectively). Significant differences in favour of HP-hMG were observed for number of blastomeres and degree of fragmentation, while uniformity of blastomere sizes, localization of fragments, frequency of multinucleation and homogeneous cytoplasm were comparable between HP-hMG and rFSH. The live birth, ongoing pregnancy and ongoing implantation rates for top-quality embryos were higher with HP-hMG than rFSH [48 versus 32 (P 0.038), 48 versus 32 (P 0.038), 41 versus 27 (P 0.032)]. Both the proportion of embryos with at least 50 surviving blastomeres after cryopreservation and embryos resuming mitosis were more frequent with HP-hMG compared with rFSH.
Composition of gonadotrophin preparations used during ovarian stimulation has an impact on some embryo quality parameters. The capacity to implant of the top-quality embryos derived from stimulation with HP-hMG appears to be improved, although the mechanism needs to be elucidated.
Document Type: Research Article
Publication date: 18 September 2007
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.