[HP-FSH (Fostimon)--a matter of choice in women with low ovarian response]

Abstract

Assisted reproductive technologies (ART) are one of the most dynamic fields of the medical science. ART beginning on 25th of July 1978 with the pioneering scientific work of P. Steptoe and B. Edwards. Although the ART have improved dramatically since 1978, the success of that treatment remains unsatisfactory. More than 25 years experience in IVF accrued in believe that a break-through in success rates can soon be reach. The guarantee of IVF success remains the good ovarian response, which very often is a challenge for reproductive specialist. The manuscript is a review of the literature about the most successful therapy for controlled ovarian stimulation for IVF in aged infertile women and/or low ovarian responders.

Conclusions: The ovarian stimulation with highly purified gonadotrophins (HP-FSH) in outlined group of patient is associated with fewer oocytes retrieval, but higher proportion of top-quality embryos compared with rFSH, an improved capacity to implant, ongoing pregnancy and live birth rate among the top-quality embryos, derived from stimulation with HP-hMG compared with top-quality embryos in the rFSH group. High purified hMG better performed than rFSH in older women and women with poor ovarian response, probably of exogenous LH activity and/or relatively higher acidic isoforms of the FSH protein (produced when lower estrogen levels are present) which may be of relevance for clinical outcome.