The Egyptian IVF-ET Centre, Department of Obstetrics & Gynaecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Gynecol Endocrinol. 2009 Jun;25(6):372-8. doi: 10.1080/09513590802630120.
Human menopausal gonadotropin (hMG) was demonstrated to be superior to recombinant FSH (rFSH) regarding clinical outcomes. It is not clear whether this change in the evidence was due to the introduction of highly purified (HP) hMG.
Systematic review of properly randomised trials comparing HP-hMG vs. rFSH in women undergoing in vitro fertilisation (IVF) and/or intracytoplasmic sperm injection (ICSI). A meticulous search was performed using electronic databases and hand searches of the literature.
Six trials (2371 participants) were included. Pooling of the trials demonstrated that the probability of clinical pregnancy following HP-hMG administration was higher than rFSH and reached borderline significance (odd ratio (O.R) = 1.21, 95% confidence interval (CI) = 1.00 to 1.45), but the ongoing pregnancy/live-birth rate was not statistically different between the two drugs, although it showed strong trends towards improvement with HP-hMG (O.R = 1.19, 95% CI = 0.98 to 1.44). Subgroup analysis comparing both drugs in IVF cycles demonstrated a statistically significant better ongoing pregnancy/live-birth rate in favour of HP-hMG (O.R = 1.31, 95% CI = 1.02 to 1.68). On the other hand, there was almost an equal ongoing pregnancy/live-birth rate in ICSI cycles (OR = 0.98, 95% CI = 0.7 to 1.36).
HP-hMG should be preferred over rFSH in women undergoing assisted reproduction, especially if IVF is the intended method of fertilisation.
人绝经促性腺激素（hMG）在临床结局方面优于重组促卵泡激素（rFSH）。尚不清楚这种证据的变化是否是由于引入了高度纯化（HP）hMG。
对比较接受体外受精（IVF）和/或胞浆内精子注射（ICSI）的女性中使用 HP-hMG 与 rFSH 的适当随机试验进行系统评价。使用电子数据库和文献的手工检索进行了细致的搜索。
纳入了 6 项试验（2371 名参与者）。对这些试验进行汇总分析表明，接受 HP-hMG 治疗后的临床妊娠概率高于 rFSH，且具有显著意义（优势比（OR）=1.21，95%置信区间（CI）=1.00 至 1.45），但两种药物的持续妊娠/活产率没有统计学差异，尽管 HP-hMG 显示出改善的强烈趋势（OR=1.19，95%CI=0.98 至 1.44）。在 IVF 周期中比较两种药物的亚组分析表明，HP-hMG 的持续妊娠/活产率具有统计学显著优势（OR=1.31，95%CI=1.02 至 1.68）。另一方面，ICSI 周期的持续妊娠/活产率几乎相等（OR=0.98，95%CI=0.7 至 1.36）。
在接受辅助生殖的女性中，HP-hMG 应优于 rFSH，尤其是如果 IVF 是预期的受精方法。
