Demirol A, Gurgan T
Clinic Women Health, Infertility and IVF Center, Hacettep University, Ankara, Turkey.
Hum Reprod. 2007 Jan;22(1):97-100. doi: 10.1093/humrep/del335. Epub 2006 Sep 5.
A comparison of the effectiveness of different gonadotrophin preparations in intrauterine insemination (IUI) cycles for patients with unexplained infertility was performed.
Two hundred and forty-one patients were prospectively randomized using computer-generated random numbers into three groups: 81 in the Follitropin alpha (Group I), 80 in the urinary FSH (uFSH) (Group II) and 80 in the hMG (Group III). The primary outcome was clinical pregnancy rate with duration of stimulation, total gonadotrophin dose, number of dominant follicles, clinical pregnancy rate, multiple pregnancy, miscarriage rate and ovarian hyperstimulation syndrome (OHSS) rate being secondary outcomes.
Clinical pregnancy rate was significantly higher in the rFSH group (25.9% in Follitropin alpha, 13.8% in uFSH and 12.5% in HMG groups; P = 0.04). There was no significant difference in terms of duration of stimulation, but mean FSH dose consumed per cycle was significantly lower in the recombinant FSH (rFSH) group compared with others (825 IU in Follitropin alpha, 1107 IU in uFSH and 1197 IU in HMG groups; P = 0.001). The number of follicles > or =16 mm diameter was significantly higher in the rFSH group compared with the uFSH and HMG groups (2.6 in Follitropin alpha, 1.3 in uFSH and 1.4 in HMG groups; P = 0.001).
rFSH may result in a better outcome in IUI cycles for unexplained infertility.
对不明原因不孕症患者在宫内人工授精(IUI)周期中使用不同促性腺激素制剂的有效性进行了比较。
241例患者通过计算机生成随机数前瞻性随机分为三组:卵泡刺激素α组81例(第一组)、尿促卵泡素(uFSH)组80例(第二组)和人绝经期促性腺激素(hMG)组80例(第三组)。主要结局为临床妊娠率,刺激持续时间、促性腺激素总剂量、优势卵泡数量、临床妊娠率、多胎妊娠、流产率和卵巢过度刺激综合征(OHSS)率为次要结局。
重组促卵泡素(rFSH)组的临床妊娠率显著更高(卵泡刺激素α组为25.9%,uFSH组为13.8%,hMG组为12.5%;P = 0.04)。刺激持续时间方面无显著差异,但重组促卵泡素(rFSH)组每个周期消耗的平均促卵泡素剂量显著低于其他组(卵泡刺激素α组为825 IU,uFSH组为1107 IU,hMG组为1197 IU;P = 0.001)。rFSH组直径≥16 mm的卵泡数量显著高于uFSH组和hMG组(卵泡刺激素α组为2.6个,uFSH组为1.3个,hMG组为1.4个;P = 0.001)。
对于不明原因不孕症患者,rFSH在IUI周期中可能会带来更好的结局。