Gynecology, Binzhou Hospital of Traditional Chinese Medicine, Binzhou, People's Republic of China.
The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China.
Drug Des Devel Ther. 2024 Sep 26;18:4359-4369. doi: 10.2147/DDDT.S479700. eCollection 2024.
The purpose of this study was to compare the efficacy of Follitropin alpha (Gonal-F) and Follitropin beta (Puregon) on cumulative live birth rate (CLBR), defined as the percentage of the number of patients who delivered for the first time in a single ovarian stimulation cycle and the number of patients in all oocyte retrieval cycles.
A retrospective cohort study including 2864 infertile patients who underwent ovarian stimulation with Puregon (group A, n=1313) and Gonal-F (group B, n=1551) was conducted between July 2015 and June 2021 at a university-affiliated reproductive medicine center. Reduce potential confounding factors between groups, propensity scores and multivariable logistic regression analyses were estimated to obtain unbiased estimates of outcomes. The primary outcome was the difference in CLBR between the two groups.
Each group identified 1160 individuals after propensity score matching (PSM). Baseline characteristics were similar between groups after PSM. The total gonadotrophin (Gn) dose (2400 vs 2325), p=0.038) and cost of Gn usage (5327.9¥ vs 7547.2¥, p<0.001) between the Puregon and Gonal-F groups were statistically significant. Nevertheless, the pregnancy outcomes between the two groups were comparable after fresh embryo transfer and subsequent frozen-thawed embryo transfer. Additionally, there was also no difference observed in the primary outcome of CLBR (52.8% vs 55.7%, p=0.169). Multivariable regression analysis revealed that the type of Gn was not associated with CLBR (p = 0.912).
Gonal-F may be a reasonable option for infertile patients who are hesitant to receive more Gn dosage injections. Furthermore, Puregon can eliminate unneeded anxiety and expenses while also administering more flexibility. Taken together, these findings could well be utilized in everyday clinical practice to better inform patients when deciding on an ovarian stimulation strategy.
本研究旨在比较卵泡刺激素α（果纳芬）和卵泡刺激素β（普利康）对累积活产率（CLBR）的影响，CLBR 定义为首次在单个卵巢刺激周期中分娩的患者比例和所有取卵周期中的患者数量。
这是一项回顾性队列研究，纳入了 2015 年 7 月至 2021 年 6 月在一所大学附属医院生殖医学中心接受普利康（A 组，n=1313）和果纳芬（B 组，n=1551）卵巢刺激的 2864 例不孕患者。为了减少组间潜在的混杂因素，进行了倾向评分和多变量逻辑回归分析，以获得结果的无偏估计。主要结局是两组间 CLBR 的差异。
在进行倾向评分匹配（PSM）后，每组各有 1160 例患者纳入分析。PSM 后两组的基线特征相似。两组间总促性腺激素（Gn）剂量（2400 vs 2325，p=0.038）和 Gn 使用费用（5327.9¥ vs 7547.2¥，p<0.001）存在统计学差异。然而，新鲜胚胎移植和随后的冻融胚胎移植后，两组的妊娠结局相当。此外，CLBR 的主要结局也没有差异（52.8% vs 55.7%，p=0.169）。多变量回归分析显示，Gn 的类型与 CLBR 无关（p=0.912）。
对于不愿意接受更多 Gn 剂量注射的不孕患者，果纳芬可能是一种合理的选择。此外，普利康在给予更多灵活性的同时，还可以消除不必要的焦虑和费用。综上所述，这些发现可以在日常临床实践中得到很好的应用，以便在决定卵巢刺激策略时为患者提供更好的信息。
