Harlin Jonas, Aanesen A, Csemiczky G, Wramsby H, Fried G
Reproductive Medical Centre, Department of Women and Child Health, Division of Obstetrics and Gynaecology, Karolinska Hospital, Stockholm, Sweden.
Hum Reprod. 2002 Feb;17(2):304-9. doi: 10.1093/humrep/17.2.304.
A prospective, semi-randomized, open, clinical study was conducted to compare ovarian response, pregnancy outcome and delivery rates using two recombinant FSH preparations (Gonal-F and Puregon) for IVF.
We analysed stimulation parameters and outcome data in 812 initiated treatment cycles where 292 women used Gonal-F and 200 used Puregon. Embryo transfer was carried out in 676 cycles. In the two preparation groups we also compared 170 women previously treated with FSH for IVF with 266 previously untreated.
The pregnancy rate with Gonal-F was 26% and with Puregon 28%. Delivery rates were identical, 22%. Clinical pregnancy and delivery rates per cycle with embryo transfer in earlier untreated women were 29.0 and 24.0%, whereas in previously treated women they were 23.5 and 18.8% respectively. After repeated cycles, delivery frequencies consecutively decreased, independent of the FSH preparation used.
Gonal-F and Puregon seem to be equally potent in achieving follicular development and equally effective, in terms of delivery rates, for use in an IVF programme. Repeated cycles resulted in equally large consecutive decreases in delivery rates, regardless of preparation choice, but were considered worthwhile for up to three stimulation cycles in selected patients.
开展了一项前瞻性、半随机、开放性临床研究,以比较两种重组促卵泡素制剂(果纳芬和普利康)用于体外受精时的卵巢反应、妊娠结局及分娩率。
我们分析了812个开始治疗周期的刺激参数和结局数据,其中292名女性使用果纳芬,200名使用普利康。676个周期进行了胚胎移植。在两个制剂组中,我们还比较了170名先前接受过促卵泡素体外受精治疗的女性与266名未接受过治疗的女性。
果纳芬的妊娠率为26%,普利康为28%。分娩率相同,均为22%。在未接受过治疗的早期女性中,每个胚胎移植周期的临床妊娠率和分娩率分别为29.0%和24.0%,而在先前接受过治疗的女性中,分别为23.5%和18.8%。重复周期后,分娩频率持续下降,与所使用的促卵泡素制剂无关。
就实现卵泡发育而言,果纳芬和普利康似乎效力相当,就分娩率而言,在体外受精方案中使用效果相同。无论选择何种制剂,重复周期都会导致分娩率同样大幅连续下降,但在部分患者中,多达三个刺激周期被认为是值得的。