The efficiency of recombinant vs. urinary gonadotropin in women of advanced reproductive age

Abstract

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.