Purposes: The following study was conducted to determine the efficiency
of recombinant vs. urinary gonadotropin in women of advanced
reproductive age. Materials and Methods: In our study,we retrospectively
compared three ovarian stimulation regimens,HMG(n=199),uFSH(n=198),and
rFSH(n=103), in the treatment of 500 infertile women≥35 years old who
were subjected to in vitro fertilization/intracytoplasmic sperm
injection cycles during a gonadotropin-releasing hormone (GnRH)
antagonist protocol. Results: Overall, the mean number of retrieved
oocytes was lower in the HMG group compared with uFSH and rFSH
groups(P=0.000),while the clinical pregnancy per started cycle
(P=0.367), implantation and live birth rate per started cycles were not
significantly different.Data were further analyzed by performing
separate comparisons of subpopulations in different age range groups,
i.e.,35-37,38-40,and>40. Major differences between the
three regimens were observed in women who were older than 40 years of
age.In this subpopulation,not only the implantation rate was higher in
the uFSH group compared with HMG and rFSH groups (P<0.05), but
the live birth rate was also significantly higher (P<0.05).In
addition,the cost-effectiveness ratio was $434.2 in HMG group,
$2,331.1 in uFSH group and $3,284.5 in rFSH group. Conclusions: In
women aged 35-39, three gonadotrophins showed no differences in
pregnancy outcomes,however,HMG is less expensive and worth
recommending.In addition,the implantation rate and live birth rate
showed a tendency toward improvement in the woman of advanced
reproductive age (age>40) in the uFSH group compared with
HMG and rFSH groups.Similarly, this more beneficial effect was also
reflected in people with AFC<5.