Comparison of Human Menopousal Gonadotropin with Recombinant Follicle Stimulating Hormone in Ovulation Stimulation During Intrauterine Insemination
American Journal of Clinical and Experimental Medicine
Volume 4, Issue 5, September 2016, Pages: 134-137
Received: Aug. 13, 2016;
Accepted: Sep. 1, 2016;
Published: Sep. 21, 2016
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Eddy Hartono, Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
Fecundability increases when ovulation induction was conducted before starting intrauterine insemination procedure (IUI). Human Menopousal gonadotrophin (HMG) and recombinant follicle stimulating hormone (rFSH) are gonadotropin hormones that are widely used in the stimulation of ovulation in infertile patients. Although comparison of gonadotropin preparations have been carried out in IVF, but comparison of rFSH preparations and HMG on IUI was still lacking. The aim of this study was to compare rFSH and HMG, each was combined with clomiphene citrate in infertile women undergone intrauterine insemination (IUI). This study was a retrospective study in the Department of Obstetrics and Gynecology Wahidin Sudirohusodo. Samples were infertile patients who meet these following criteria: women aged 20-45 years, infertility of unknown cause for approximately 12 months, had a history of induced ovulation for approximately 6 cycles without IUI, IVF or ICSI, patent tubes examined with hysterosalpingography, and normal semen analysis according to 1999 WHO criteria. A total of 78 patients consisted of 30 patients using clomiphene citrate + rFSH and 48 other patients using clomiphene citrate + HMG. In two groups, total dosage, duration of gonadotropin administration, follicle count, mean size of follicles, endometrial line size and pregnancy were compared. Statistical test using Levene T and unpaired t test was conducted using SPSS 16 for Windows version. There was no statistically significant difference among total dosage, duration of gonadotropins administration, follicle counts, mean size of follicles, and endometrial line size. The mean number of pregnancy was higher in patients treated with clomiphene citrate + hMG but this difference was not statistically significant. hMG and rFSH was equally effective in stimulating ovulation in intrauterine insemination.
Comparison of Human Menopousal Gonadotropin with Recombinant Follicle Stimulating Hormone in Ovulation Stimulation During Intrauterine Insemination, American Journal of Clinical and Experimental Medicine.
Vol. 4, No. 5,
2016, pp. 134-137.
Berek Jonathan S. Berek & Novak Gynecology 14th edition, Lippincot, Williams &Wilkins. 2007.
Ng, E. H, Lau, E. Y. L. Yeung, W. S. B and Ho, P. C. HMG is as good as recombinant human FSH in terms of oocyte and embryo quality: a prospective randomized trial. 2001. Hum, Reprod. 16, 319-325.
Sperrof L, Fritz MA. Clinical gynecologic endocrinology and infertility. 8th ed. Philadelpia: Lippincot Williams and Wilkins; 2011. p. 2337-2341.
Siristatidis C, Trivella M, Chrelias C, Sioulas VD, Vrachnis N, Kassanos D. A short narrative review of the feasibility of adopting mild ovarian stimulation for IVF as the current standard of care. Arch Gynecol Obstet 2012; 286: 505-10.
Giudice, F. Crisci, C., Eshkol, A, et al. Composition of commercial gonadotropin preparations extracted from human post menopausal urine; characterization of non gonadotropin proteins. Hum. Reprod. 1994; 9, 2291-2299.
Pouwer AW, Farquhar C, Kremer JA. Long acting FSH versus daily FSH for women undergoing assisted reproduction. Cochrane Database Syst Rev 2012; 13; 6CD009577.
Reindolar RH, Goldman MB, Gonadotropin therapy: A 20th century relic. Fertil steril 2012; 97: 813-18.
Beall SA, DeCherney A. History and challenges surrounding ovarian stimulation in the treatment of infertility. Fertil Steril 2012; 97: 795-801.
Loumaye E, Engrand P, Shoham Z, Hillier SG, Baird DT. Clinical evidence of an LH ‘ceiling’ effect induced by administration of recombinant human LH during the late follicular phase of stimulation cycles in World Health Organization type I and type II anovulation. Hum Reprod 2003; 18: 314–22.
Bjercke S, Tanbo T, Abyholm T, Omland A, Opoien HK, Fedorcsak P. Clinical outcome following stimulation with highly purified hMG or recombinant FSH in patients undergoing their first treatment cycle of IVF or ICSI. Acta Obstet Gynecol Scand 2010; 89: 1053–60.
Pacchiarotti A, Sbracia M, Frega A, Selman H, Rinaldi L, Pacchiarotti A. Urinary hMG (Meropur) versus recombinant FSH plus recombinant LH (Pergoveris) in IVF: a multicenter, prospective, randomized controlled trial. Fertil Steril 2010; 94: 2467–9.
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: 540–44.
Kilani Z, Dakkak A, Ghunaim S, Cognigni GE, Tabarelli C, Parmegiani L et al. A prospective, randomized, controlled trial comparing HP-hMG with r- FSH in women undergoing ICSI: ovarian response and clinical outcomes. Hum Reprod 2003; 18: 1194–9.
Al-Inany H, Aboulghar M, Mansour R, Serour G. Meta-analysis of recombinant versus urinary derived FSH: an update. Hum Reprod 2003; 18: 305-13.
Al-Inany H, Aboulghra MA, Mansour RT, Seour GI. Ovulation induction in the new millennium: recombinant follicle stimulating hormone versus human menopausal gonadotropin. Gynecol Endocrinol 2005; 20: 161-9.
Van Wely M, Westergaard LG, Bossuyt PM, Van der Veen F. Human Menopousal Gonadotropin versus recombinant Follicle Stimulation hormone for ovarian stimulation in assisted reproductive cycles. Cochrane Database Syst Rev 2011; 16.
Al-Inany HG, Abou-Setta AM, Aboulghar MA, Monsour RT, Serour GI. Efficacy and safety of human menopausal gonadotropins versus recombinant FSH: a meta-analysis. RBM Online 2008; 16: 81-8.
Rashidi, Mandana, et al. Advantages of recombinant FSH over human menopausal gonadatropin for ovarian stimulation in intrauterine insemination: a randomized clinical trial in unexplained infertility. European Journal of Obstetric and Gynecology and Reproductive Biology 2013; 244-247.
World Health Organization. WHO Laboratory manual for the examination of human semen and semen cervical mucus interaction (5th ed). WHO Press, World Health Organization, 1999.
Phipps, W. R, Holden D and Sheehan, R. K. Use of recombinant human follicle stimulating hormone for in vitro fertilization embryo transfer after severe systemic immunoglobulin E-mediated reaction to urofollitropin. 1996. Fertil. steril, 66, 148-150.
Rogers, M., McLoughlin, J. D, Lambert, A. et al. Variability in the immunoreactive and bioactive follicle stimulating hormone content of human urinary menopausal gonadotrophin preparation. Hum. Reprod., 10, 1982-1986.
Daya, S., Gunby, J., Hughes, E. G. et al. Follicle stimulating hormone versus human menopausal gonadotropin for in vitro fertilization cycles: a meta analysis. 1995. Fertil Steril, 64, 347-354.
The European and Israeli Study Group on Highly Menotropin versus Recombinant Follicle Stimulating Hormone. Efficacy and safety of highly purified menotropin versus recombinant follicle stimulating hormone in in vitro fertilization/intracytoplasmic sperm injection cycles: a randomized, comparative trial. Fertil Steril 2002; 78: 520-28.
Platteau P, Andersen AN, Balen A, Devroey P, Sorenson P, Helmgaard L, et al. Similar ovulation rates, but different follicular development with highly purified menotropin compared with r FSH in WHO group II anovulatory infertility: a randomized controlled study. Hum Reprod 2006; 21: 1798-804.
Kocak M, Dilbaz B, Demir B, et al. Lyophilised hMG versus rFSH in women with unexplained infertility undergoing a controlled ovarian stimulation with intrauterine insemination: a prospective, randomized study. Gynecological Endocrinology 2010; 26: 429-434.
Turhan, N, Pekel A, Ayrim A, Kasap, B, Bayrak, O Effectiveness HP-HMG versus rFSH in patients undergoing IVF/ICSI cycles with moderate male factor infertility. Turk J Med Sci. 2013 43: 144-149.
Tabata, Chisa, Fujiwara, Toshihiro, et. al. Comparison of FSH and hMG on ovarian stimulation outcome with a GnRH antagonist protocol in younger and advanced reproductive age women.. Reproductive Medicine and Biology; Januari 2015, Vol 14 issue 1, p 5.