Corifollitropin alfa compared to daily FSH in controlled ovarian stimulation for in vitro fertilization: a meta-analysis

Abstract

The present study offers a meta-analysis of published randomized controlled trials (RCTs) evaluating the outcomes of in vitro fertilization (IVF) cycles using corifollitropin alfa for controlled ovarian stimulation (COS) in comparison with daily recombinant FSH (rFSH). The study examined seven RCTs including 2138 patients receiving corifollitropin alfa and 1788 women receiving daily rFSH for COS. As a novel aspect, this meta-analysis included two specific subpopulations of IVF patients, i.e. egg donors and poor responders. There were no significant differences between corifollitropin alfa and rFSH with respect to the majority of the clinical parameters considered, and comparable were the outcomes in terms of live birth rate, ongoing pregnancy rate, and clinical pregnancy rate. Women receiving corifollitropin alfa had a significantly higher number of metaphase II oocytes at ovum pick-up, and number of formed embryos, in comparison to rFSH. The risk of cycle cancellation due to overstimulation was significantly higher in the corifollitropin alfa group. Ovarian hyperstimulation syndrome (OHSS) incidence was statistically comparable between patients receiving long lasting or daily rFSH. Nevertheless, in view of the fact that corifollitropin alfa resulted in a higher number of metaphase II oocytes collected and a higher number of cycles cancelled due to overstimulation, corifollitropin alfa should be cautiously considered in women with the potential of being hyper responders.

FSH for the Treatment of Male Infertility

“…In fact, in cultured primary human granulosa cells, corifollitropin was demonstrated to be more potent than FSH in increasing aromatase gene expression [88], suggesting a high capability of inducing estrogen synthesis. This finding supports in vivo observations reporting that women treated with corifollitropin alpha have a higher number of metaphase II oocytes at ovum pick-up and of formed embryos, as well as higher overstimulation risk compared to FSH (parameters are highly dependent on the estrogenic functions but require further examinations in vivo) [89].…”

Long‐acting recombinant follicle‐stimulating hormone in random‐start ovarian stimulation protocols for fertility preservation in women with cancer

“…In this regard, it has to be also underlined that our findings are in line with the available evidence in healthy women. Indeed, the effectiveness of long‐acting recombinant FSH for ovarian stimulation in general is well‐established .…”

“…In this regard, it has to be also underlined that our findings are in line with the available evidence in healthy women. Indeed, the effectiveness of long-acting recombinant FSH for ovarian stimulation in general is well-established (13,14). The routine use of long-acting recombinant FSH in the setting of fertility preservation for women with malignancies has the important advantage of reducing the burden of ovarian stimulation.…”

Comparison of corifollitropin alfa and daily recombinant follicle-stimulating hormone in poor responder patients undergoing in vitro fertilization cycles

“…In addition, basal FSH values for high ovarian response and menstrual cycle length for poor ovarian response were prognostic. In a meta-analysis consisting of 2138 women who were randomized to receive corifollitropin alfa and 1788 who were randomized to receive daily rFSH, Fensore et al ( 17 ) emphasized that the risk of cycle cancellation due to overstimulation was significantly higher in the CFA group. On the other hand, the incidence of OHSS was comparable between patients receiving long-lasting or daily rFSH.…”