Prasetiawati Novita, Sundari Ayu Mulia, Supriyadi Agus, Sjarbaini Hadi, Tarigan Sudirmanto, Suardana Gde, Pariyanti Gangsar, Indah Deana Rosaria, Purwatyningsih Euis, Bowolaksono Anom
Graduate School of Biology, Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Indonesia, Depok, Indonesia.
Cellular and Molecular Mechanisms in Biological Systems (CEMBIOS) Research Group, Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Indonesia, Depok, Indonesia.
J Reprod Infertil. 2023 Apr-Jun;24(2):139-144. doi: 10.18502/jri.v24i2.12499.
Follitropin alfa (FA) is one of the most widely used exogenous gonadotropins in both agonist and antagonist protocols for controlled ovarian stimulation (COS) and in vitro fertilization (IVF). However, reports of its effectiveness are limited, particularly in terms of its impact on overall IVF outcomes and ovarian hyperstimulation syndrome (OHSS). Therefore, in this study, FA competency was investigated by evaluating its effect on IVF outcomes and OHSS, administering agonist and antagonist COS protocols.
A retrospective study with 120 subjects was conducted. Outcomes comprising the number of retrieved and fertilized oocytes, quality of embryos, and clinical pregnancies were assessed. Statistical correlation between FA dose, IVF outcomes, and the incidence of OHSS was also analyzed. All statistical analyses were performed at 95% confidence level.
There was no significant difference in both protocols regarding retrieved oocytes (p=0.604), fertilized oocytes (p=0.761), embryo quality including good, average, poor embryo (p=0.875, p=0.565, p=0.785), and clinical pregnancy (p= 0.844). However, FA doses in the agonist protocol were shown notably higher (p= 0.001). Negative correlations were also observed between FA dose and the number of retrieved oocytes (r=-0.255, p<0.01), fertilized oocytes (r=-0.296, p<0.01), and good quality embryos (r=-0.231, p<0.05).
Our study suggested that FA yields similar outcomes in both COS protocols, but agonist protocols require higher doses of FA and evaluation of its effect on OHSS is an important area of research for further investigation.
在激动剂和拮抗剂方案中,用于控制性卵巢刺激(COS)和体外受精(IVF)时,重组人促卵泡素α(FA)是使用最广泛的外源性促性腺激素之一。然而,关于其有效性的报道有限,特别是在其对整体IVF结局和卵巢过度刺激综合征(OHSS)的影响方面。因此,在本研究中,通过评估其对IVF结局和OHSS的影响,并采用激动剂和拮抗剂COS方案,对FA的效能进行了研究。
进行了一项涉及120名受试者的回顾性研究。评估了包括回收的和受精的卵母细胞数量、胚胎质量和临床妊娠等结局。还分析了FA剂量、IVF结局与OHSS发生率之间的统计相关性。所有统计分析均在95%置信水平下进行。
两种方案在回收的卵母细胞(p=0.604)、受精的卵母细胞(p=0.761)、胚胎质量(包括优质、中等、劣质胚胎,p=0.875、p=0.565、p=0.785)和临床妊娠(p=0.844)方面均无显著差异。然而,激动剂方案中的FA剂量显著更高(p=0.001)。还观察到FA剂量与回收的卵母细胞数量(r=-0.255,p<0.01)、受精的卵母细胞数量(r=-0.296,p<0.01)以及优质胚胎数量(r=-0.231,p<0.05)之间呈负相关。
我们的研究表明,在两种COS方案中FA产生的结局相似,但激动剂方案需要更高剂量的FA,并且评估其对OHSS的影响是进一步研究的一个重要领域。