Ovarian response to recombinant human follicle-stimulating hormone: a randomized, antimüllerian hormone–stratified, dose–response trial in women undergoing in vitro fertilization/intracytoplasmic sperm injection

Arce, Joan‐Carles; Andersen, Anders Nyboe; Sánchez, Manuel Fernández; Višňová, Hana; Bosch, Ernesto; García-Velasco, Juan A.; Barri, Pedro N.; Sutter, Petra De; Klein, Bjarke M.; Fauser, Bart C.J.M.

doi:10.1016/j.fertnstert.2014.08.013

Cited by 149 publications

(139 citation statements)

References 29 publications

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“…In this context, a recent study has been unable to find a linear relationship between FSH doses and the overall number of blastocysts or by AMH strata. Thus a threshold level may exist for starting the gonadotropin dose, and no more competent oocytes can be obtained if it is exceeded [12]. …”

Section: Discussionmentioning

confidence: 99%

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A Higher Ovarian Response after Stimulation for IVF Is Related to a Higher Number of Euploid Embryos

Labarta

Bosch

Mercader

et al. 2017

BioMed Research International

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This study has analysed the relationship between ovarian response and the number of euploid embryos. This is a post hoc analysis of a subset of data generated during a prospective cohort study previously published. Forty-six oocyte donors were subjected to ovarian stimulation with 150 IU of rFSH and 75 IU of hp-hMG in a GnRH agonist long protocol. Preimplantation genetic screening was performed in all viable embryos. We observed a positive relationship between ovarian response and the number of euploid embryos. When ovarian response was above the median (≥17 oocytes), the mean number of euploid embryos per donor was 5.0 ± 2.4, while when <17 oocytes were obtained the mean number of euploid embryos was 2.7 ± 1.4 (p = 0.000). Aneuploidy rate did not increase with ovarian response or gonadotropin doses. Also, the number of euploid embryos was inversely related to the amount of gonadotropins needed per oocyte obtained (ovarian sensitivity index). These results suggest that the number of euploid embryos available for embryo transfer increases as the number of oocytes obtained does. Considering the total number of euploid embryos seems more relevant than the aneuploidy rate.

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Section: Discussionmentioning

confidence: 99%

“…It has been recently suggested that a threshold level for gonadotropin doses may exist and that no more competent oocytes can be obtained if it is exceeded [12]. …”

Section: Introductionmentioning

confidence: 99%

A Higher Ovarian Response after Stimulation for IVF Is Related to a Higher Number of Euploid Embryos

Labarta

Bosch

Mercader

et al. 2017

BioMed Research International

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“…Recently follitropin delta has been described (FE 999049), the first recombinant FSH protein in clinical development that is expressed in a human cell line (PER.C6), with individualized dosing optimized based on each patient’s weight and anti-Mullerian hormone (AMH) level (10, 11, 12). In female volunteers, follitropin delta displayed distinct pharmacokinetics and pharmacodynamics, with higher exposure and lower serum clearance than follitropin alfa (13).…”

Section: Introductionmentioning

confidence: 99%

Comparative pharmacology of a new recombinant FSH expressed by a human cell line

Koechling

Plaksin²,

Croston³

et al. 2017

Endocrine Connections

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Recombinant FSH proteins are important therapeutic agents for the treatment of infertility, including follitropin alfa expressed in Chinese Hamster Ovary (CHO) cells and, more recently, follitropin delta expressed in the human cell line PER.C6. These recombinant FSH proteins have distinct glycosylation, and have distinct pharmacokinetic and pharmacodynamic profiles in women. Comparative experiments demonstrated that follitropin delta and follitropin alfa displayed the same in vitro potency at the human FSH receptor, but varied in their pharmacokinetics in mouse and rat. While follitropin delta clearance from serum depended in part on the hepatic asialoglycoprotein receptor (ASGPR), follitropin alfa clearance was unaffected by ASGPR inhibition in rat or genetic ablation in mice. The distinct properties of follitropin delta and follitropin alfa are likely to contribute to the differing pharmacokinetic and pharmacodynamic profiles observed in women and to influence their efficacy in therapeutic protocols for the treatment of infertility.

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“…Despite this, clinicians frequently use large doses of gonadotrophins to try to attain large oocyte yields in excess of 15 oocytes, with the underlying belief that this will improve the overall chances of success. However, large oocyte yields have not been shown to be accompanied by an increase in good-quality blastocysts [11], and RCTs have shown a decrease in fresh embryo transfer associated live-birth rates in women with high oocyte yields [12].…”

Section: Avoid Aggressive Ovarian Stimulationmentioning

confidence: 99%

Prevention and management of ovarian hyperstimulation syndrome

Nelson

2017

Thrombosis Research

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Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication of ovarian stimulation. It is feasible to identify patients at risk, modify stimulation strategies to ameliorate risk, and initiate out-patient treatments that alter disease pathophysiology to reduce disease severity. Mitigation of OHSS risk and severity, through innovative approaches prior to treatment, during treatment and after treatment should now be the standard care. This review summarizes recent developments and provides recommendations on the prevention and treatment of OHSS.3

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Ovarian response to recombinant human follicle-stimulating hormone: a randomized, antimüllerian hormone–stratified, dose–response trial in women undergoing in vitro fertilization/intracytoplasmic sperm injection

Abstract: NCT01426386.

Cited by 149 publications

References 29 publications

A Higher Ovarian Response after Stimulation for IVF Is Related to a Higher Number of Euploid Embryos

A Higher Ovarian Response after Stimulation for IVF Is Related to a Higher Number of Euploid Embryos

Comparative pharmacology of a new recombinant FSH expressed by a human cell line

Prevention and management of ovarian hyperstimulation syndrome

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