Effects of different gonadotropin preparations in GnRH antagonist protocol for patients with polycystic ovary syndrome during IVF/ICSI: a retrospective cohort study

doi:10.3389/fendo.2024.1309993

. 2024 Feb 12:15:1309993.

doi: 10.3389/fendo.2024.1309993. eCollection 2024.

Effects of different gonadotropin preparations in GnRH antagonist protocol for patients with polycystic ovary syndrome during IVF/ICSI: a retrospective cohort study

Zhengyan Hu^#^{1

2

3}, Rujun Zeng^#^{1

2}, Rui Gao^{1

2}, Mingli Chen^{4

5}, Xiumei Liu^{4

5}, Qiong Zhang^{4

5}, Lang Qin^{1

2}, Xun Zeng^{1

2}

Affiliations

¹ The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
² Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
³ West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
⁴ Department of Obstetrics and Gynecology, Ziyang Maternal and Child Health Care Hospital, Ziyang, Sichuan, China.
⁵ West China Second University Hospital, Sichuan University, Ziyang Women's and Children's Hospital, Ziyang, Sichuan, China.

^# Contributed equally.

PMID: 38410698
PMCID: PMC10895441
DOI: 10.3389/fendo.2024.1309993

Effects of different gonadotropin preparations in GnRH antagonist protocol for patients with polycystic ovary syndrome during IVF/ICSI: a retrospective cohort study

Zhengyan Hu et al. Front Endocrinol (Lausanne). 2024.

. 2024 Feb 12:15:1309993.

doi: 10.3389/fendo.2024.1309993. eCollection 2024.

Authors

Zhengyan Hu^#^{1

2

3}, Rujun Zeng^#^{1

2}, Rui Gao^{1

2}, Mingli Chen^{4

5}, Xiumei Liu^{4

5}, Qiong Zhang^{4

5}, Lang Qin^{1

2}, Xun Zeng^{1

2}

Affiliations

¹ The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
² Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
³ West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
⁴ Department of Obstetrics and Gynecology, Ziyang Maternal and Child Health Care Hospital, Ziyang, Sichuan, China.
⁵ West China Second University Hospital, Sichuan University, Ziyang Women's and Children's Hospital, Ziyang, Sichuan, China.

^# Contributed equally.

PMID: 38410698
PMCID: PMC10895441
DOI: 10.3389/fendo.2024.1309993

Abstract

Purpose: To compare the effects of recombinant FSH alfa (rFSH-alfa), rFSH-beta, highly purified human menopausal gonadotropin (HP-hMG) and urinary FSH (uFSH) in women with polycystic ovarian syndrome who have undertaken the GnRH antagonist protocol during IVF/ICSI treatment.

Method: A single-center retrospective cohort study including women with PCOS who received the GnRH antagonist protocol from January 2019 to July 2022 was conducted. Patients were divided into rFSH-alfa group, HP-hMG group, uFSH group, and rFSH-beta group, and the number of oocytes retrieved, clinical pregnancy rate of the fresh cycle (primary outcomes), embryo quality, and severe OHSS rate (secondary outcomes) were compared.

Results: No statistical differences were found among the four groups in fresh cycle clinical pregnancy rate (p=0.426), nor in the subgroup analyses. The HP-hMG group had a smaller number of oocytes retrieved and a higher high-quality D3 embryo rate than the three FSH groups (p<0.05). No statistical differences were found among the four groups in the severe OHSS rate (p=0.083).

Conclusion: For women with PCOS undergoing the GnRH antagonist protocol, the clinical pregnancy rates of fresh IVF/ICSI-ET cycle are similar for all four types of Gn. With a lower risk of OHSS and a similar number of high-quality and available embryos, HP-hMG may have an advantage in the PCOS population.

Keywords: GnRH antagonist protocol; ICSI; IVF; gonadotropin; polycystic ovary syndrome.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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References

1. McCartney CR, Marshall JC. CLINICAL PRACTICE. Polycystic ovary syndrome. N Engl J Med (2016) 375(1):54–64. doi: 10.1056/NEJMcp1514916 - DOI - PMC - PubMed
1. Costello MF, Misso ML, Balen A, Boyle J, Devoto L, Garad RM, et al. . Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility. Hum Reprod Open (2019) 2019(1):hoy021. doi: 10.1093/hropen/hoy021 - DOI - PMC - PubMed
1. Broer SL, Dólleman M, Opmeer BC, Fauser BC, Mol BW, Broekmans FJM. AMH and AFC as predictors of excessive response in controlled ovarian hyperstimulation: a meta-analysis. Hum Reprod Update (2011) 17(1):46–54. doi: 10.1093/humupd/dmq034 - DOI - PubMed
1. La Marca A, Sunkara SK. Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum Reprod Update (2014) 20(1):124–40. doi: 10.1093/humupd/dmt037 - DOI - PubMed
1. Lambalk CB, Banga FR, Huirne JA, Toftager M, Pinborg A, Homburg R, et al. . GnRH antagonist versus long agonist protocols in IVF: a systematic review and meta-analysis accounting for patient type. Hum Reprod Update (2017) 23(5):560–79. doi: 10.1093/humupd/dmx017 - DOI - PubMed

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[1] McCartney CR, Marshall JC. CLINICAL PRACTICE. Polycystic ovary syndrome. N Engl J Med (2016) 375(1):54–64. doi: 10.1056/NEJMcp1514916 - DOI - PMC - PubMed

[2] McCartney CR, Marshall JC. CLINICAL PRACTICE. Polycystic ovary syndrome. N Engl J Med (2016) 375(1):54–64. doi: 10.1056/NEJMcp1514916 - DOI - PMC - PubMed

[3] Costello MF, Misso ML, Balen A, Boyle J, Devoto L, Garad RM, et al. . Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility. Hum Reprod Open (2019) 2019(1):hoy021. doi: 10.1093/hropen/hoy021 - DOI - PMC - PubMed

[4] Costello MF, Misso ML, Balen A, Boyle J, Devoto L, Garad RM, et al. . Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility. Hum Reprod Open (2019) 2019(1):hoy021. doi: 10.1093/hropen/hoy021 - DOI - PMC - PubMed

[5] Broer SL, Dólleman M, Opmeer BC, Fauser BC, Mol BW, Broekmans FJM. AMH and AFC as predictors of excessive response in controlled ovarian hyperstimulation: a meta-analysis. Hum Reprod Update (2011) 17(1):46–54. doi: 10.1093/humupd/dmq034 - DOI - PubMed

[6] Broer SL, Dólleman M, Opmeer BC, Fauser BC, Mol BW, Broekmans FJM. AMH and AFC as predictors of excessive response in controlled ovarian hyperstimulation: a meta-analysis. Hum Reprod Update (2011) 17(1):46–54. doi: 10.1093/humupd/dmq034 - DOI - PubMed

[7] La Marca A, Sunkara SK. Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum Reprod Update (2014) 20(1):124–40. doi: 10.1093/humupd/dmt037 - DOI - PubMed

[8] La Marca A, Sunkara SK. Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum Reprod Update (2014) 20(1):124–40. doi: 10.1093/humupd/dmt037 - DOI - PubMed

[9] Lambalk CB, Banga FR, Huirne JA, Toftager M, Pinborg A, Homburg R, et al. . GnRH antagonist versus long agonist protocols in IVF: a systematic review and meta-analysis accounting for patient type. Hum Reprod Update (2017) 23(5):560–79. doi: 10.1093/humupd/dmx017 - DOI - PubMed

[10] Lambalk CB, Banga FR, Huirne JA, Toftager M, Pinborg A, Homburg R, et al. . GnRH antagonist versus long agonist protocols in IVF: a systematic review and meta-analysis accounting for patient type. Hum Reprod Update (2017) 23(5):560–79. doi: 10.1093/humupd/dmx017 - DOI - PubMed

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Effects of different gonadotropin preparations in GnRH antagonist protocol for patients with polycystic ovary syndrome during IVF/ICSI: a retrospective cohort study

Affiliations

Effects of different gonadotropin preparations in GnRH antagonist protocol for patients with polycystic ovary syndrome during IVF/ICSI: a retrospective cohort study

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