Abstract | BACKGROUND: Randomized trials (RCTs) and systematic reviews have challenged the claim for superiority of recombinant follicle-stimulating hormone (recFSH) compared with human-derived FSH ( hFSH). Even so, much of the evidence comes from unavailable products. If the efficacy of the currently available Fostimon(®) is superior, the off-market Metrodin-HP(®), then data from the latter should not be used, gauge of the former. METHODS: Electronic/hand searches were performed to identify RCTs comparing Fostimon(®) vs. Metrodin-HP(®) or either product with recFSH. Primary outcomes were live-birth rate (LBR), ongoing pregnancy rate (OPR), and OPR/LBR. Secondary outcomes were clinical pregnancy rate ( CPR), multiple pregnancy rate (MPR), ovarian hyperstimulation syndrome (OHSS), abortion rates, and cycle demographics. Data were extracted, allowed for an intention-to-treat analysis, and meta-analyzed using combined direct/adjusted indirect methods. RESULTS: Twenty-two RCTs met the inclusion criteria: Fostimon(®) vs. Metrodin-HP(®) (n = 2); Fostimon(®) vs. recFSH (n = 8); and Metrodin-HP(®) vs. recFSH (n = 12). LBR (odds ratio = 1.72; 95% confidence interval = 1.05-2.80), OPR/LBR, and CPR were all significantly higher favoring Fostimon(®). OPR, MPR, OHSS, and miscarriage rates were not significantly different. Pooled results for cycle demographics were not reported due to high heterogeneity. Conclusions. Fostimon(®) is superior to Metrodin-HP(®) regarding clinical outcomes. Therefore, care should be taken not to assume that all hFSH products have the same efficacy.
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Authors | Hesham G Al-Inany, Ahmed M Abou-Setta |
Journal | Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
(Gynecol Endocrinol)
Vol. 28
Issue 2
Pg. 94-101
(Feb 2012)
ISSN: 1473-0766 [Electronic] England |
PMID | 21591977
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Chemical References |
- Follicle Stimulating Hormone, Human
- Urofollitropin
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Topics |
- Female
- Fertilization in Vitro
- Follicle Stimulating Hormone, Human
(standards)
- Humans
- Pregnancy
- Pregnancy Outcome
- Pregnancy Rate
- Randomized Controlled Trials as Topic
- Sperm Injections, Intracytoplasmic
- Treatment Outcome
- Urofollitropin
(standards)
|