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Fertility and Sterility Aug 2020To evaluate the efficacy and safety of highly purified human menotropin (HP-hMG) and recombinant follicle-stimulating hormone (rFSH) for controlled ovarian stimulation... (Comparative Study)
Comparative Study
Randomized, assessor-blinded trial comparing highly purified human menotropin and recombinant follicle-stimulating hormone in high responders undergoing intracytoplasmic sperm injection.
OBJECTIVE
To evaluate the efficacy and safety of highly purified human menotropin (HP-hMG) and recombinant follicle-stimulating hormone (rFSH) for controlled ovarian stimulation in a population of patients predicted to be high responders.
DESIGN
Randomized, open-label, assessor-blinded, parallel-group, noninferiority trial.
SETTING
Fertility centers.
PATIENT(S)
A total of 620 women with serum antimüllerian hormone (AMH) ≥5 ng/mL.
INTERVENTION(S)
Controlled ovarian stimulation with HP-hMG or rFSH in a GnRH antagonist assisted reproductive technology (ART) cycle. Fresh transfer of a single blastocyst was performed unless ovarian response was excessive, in which all embryos were cryopreserved. Subjects could undergo subsequent frozen blastocyst transfer within 6 months of randomization.
MAIN OUTCOME MEASURE(S)
Ongoing pregnancy rate (OPR) after fresh transfer (primary endpoint), as well as cumulative live birth, ovarian hyperstimulation syndrome (OHSS), and pregnancy loss rates.
RESULTS
OPR/cycle start after fresh transfer was 35.5% with HP-hMG and 30.7% with rFSH (difference: 4.7%, 95% CI -2.7%, 12.1%); noninferiority was established. Compared to rFSH, HP-hMG was associated with significantly lower OHSS (21.4% vs. 9.7% respectively; difference: -11.7%, 95% CI -17.3%, -6.1%) and cumulative early pregnancy loss rates (25.5% vs. 14.5% respectively; difference: -11.0%, 95% CI -18.8%, -3.14%). Despite 43 more transfers in the rFSH group, cumulative live birth rates were similar with HP-hMG and rFSH at 50.6% and 51.5% respectively (difference: -0.8%, 95% CI -8.7%, 7.1%).
CONCLUSION(S)
In high responders, HP-hMG provided comparable efficacy to rFSH with fewer adverse events, including pregnancy loss, suggesting its optimized risk/benefit profile in this population.
CLINICAL TRIAL REGISTRATION NUMBER
NCT02554279 (clinicaltrials.gov).
Topics: Abortion, Spontaneous; Adult; Anti-Mullerian Hormone; Biomarkers; Female; Fertility; Fertility Agents, Female; Follicle Stimulating Hormone, Human; Humans; Infertility; Live Birth; Male; Menotropins; Ovarian Hyperstimulation Syndrome; Ovary; Ovulation; Ovulation Induction; Pregnancy; Pregnancy Rate; Prospective Studies; Recombinant Proteins; Single Embryo Transfer; Sperm Injections, Intracytoplasmic; Treatment Outcome; United States; Young Adult
PubMed: 32416978
DOI: 10.1016/j.fertnstert.2020.03.029 -
Journal of Assisted Reproduction and... Apr 1992Two protocols were scheduled for in vitro fertilization and embryo transfer (IVF-ET) in patients with various stages of endometriosis who were resistant to conventional... (Comparative Study)
Comparative Study
Two protocols were scheduled for in vitro fertilization and embryo transfer (IVF-ET) in patients with various stages of endometriosis who were resistant to conventional therapies. In the ultralong protocol (21 patients), gonadotropin releasing hormone agonist (Gn-RHa) was administered for at least 60 days prior to ovarian stimulation along with menotropin until human chorionic gonadotropin was injected. In the long protocol (11 patients), Gn-RHa was started at the midluteal phase and exogenous gonadotropin was commenced between the third and the seventh day of the menstrual cycle after pituitary suppression. The estradiol response and the number of retrieved oocytes, fertilized oocytes, cleaved oocytes, and transferred embryos were similar in both groups but the clinical pregnancy rate per transfer was superior in the ultralong protocol (67 vs 27%). The miscarriage rate was 14% (2/14) in the ultralong protocol. Prolonged Gn-RHa suppression of ovarian function before superovulation may overcome some causes of infertility in patients with endometriosis.
Topics: Adult; Antigens, Tumor-Associated, Carbohydrate; Buserelin; Endometriosis; Female; Fertilization in Vitro; Humans; Infertility, Female; Menotropins; Ovulation Induction; Pregnancy; Treatment Outcome
PubMed: 1627925
DOI: 10.1007/BF01203749 -
Fertility and Sterility Oct 1987Women who conceive with human gonadotropins have a high rate of spontaneous abortions. The causes for this poor outcome are unknown. In a retrospective analysis, the...
Women who conceive with human gonadotropins have a high rate of spontaneous abortions. The causes for this poor outcome are unknown. In a retrospective analysis, the authors analyzed potential factors in 45 menotropin-treated patients with spontaneous first-trimester miscarriages. Data were compared with 119 menotropin-treated patients who conceived and delivered viable infants. Patient factors that were analyzed included the following: age, history of past miscarriages, duration of infertility, diagnostic category, weight, body surface area, duration and weight-corrected dose of menotropin administration, maximum estradiol level, estradiol pattern, human chorionic gonadotropin (hCG) dose, presence or absence of hCG support in the luteal phase, results of postcoital testing, methods of insemination, and results of husband's semen analysis. There was a significant difference between the miscarriage group and the control group in regard to age and weight distribution. All other characteristics were not significantly different. Patients over 81.8 kg as well as patients aged 35 years and older were both significantly (P less than 0.01) at increased risk to have a spontaneous first-trimester miscarriage. The data suggest that obesity and advanced age contribute to the high miscarriage rate in menotropin-treated patients. It appears reasonable to suggest that women weighing more than 81.8 kg should make every effort to lose weight before beginning menotropin therapy.
Topics: Abortion, Spontaneous; Adult; Age Factors; Body Weight; Chorionic Gonadotropin; Estradiol; Female; Humans; Infertility; Menotropins; Pregnancy; Retrospective Studies; Risk Factors
PubMed: 3115834
DOI: 10.1016/s0015-0282(16)59466-7 -
Fish Physiology and Biochemistry Oct 2021The applications of exogenous hormones in different species for the induction of oocyte production, final oocyte maturation (FOM), and spawning for their reproduction is...
The applications of exogenous hormones in different species for the induction of oocyte production, final oocyte maturation (FOM), and spawning for their reproduction is getting more attention day by day. The current preliminary research work was carried out to induce breeding in Clarias gariepinus, commonly known as African catfish, imported from Thailand. Single doses of two hormones as Ovaprim and human menopausal gonadotropin (hMG) were used and the research work was carried out at Muzaffargarh Fish Hatchery Punjab, Pakistan. A total of twenty-four (n = 24) C. gariepinus were selected having body weight approximately 2 kg and divided into two main groups based on gender as male (n = 12) and female (n = 12). For milt collection, all males were treated with Ovaprim 0.5 mg/kg body weight (b.w.) and female fish were divided into three groups as A, B, and C with four (n = 4) fish in each group. Group A was injected with only normal saline (control group) while fish in group B and group C were treated with hMG at 0.5 mg/kg b.w. and Ovaprim 0.5 mg/kg b.w., respectively. Then, after 6 h of hormone injections until 48 h, spawned eggs, eggs' weight, fertilization rate, hatching rate, survival rate, fecundity, and deformed larvae were investigated. The results revealed that Ovaprim injection significantly (p < 0.05) modulate the reproductive parameters in group C while no breeding was induced in both control and hMG-treated groups. Hence, it could be concluded that Ovaprim has the potential to induce breeding in African catfish, while in the current study, hMG failed to induce breeding. However, trials at large scales are required to further explore the effect of different doses of both tested hormones by increasing the treated subjects particularly in Pakistani fish farms.
Topics: Animals; Body Weight; Breeding; Catfishes; Domperidone; Drug Combinations; Female; Gonadotropin-Releasing Hormone; Male; Menotropins
PubMed: 34406590
DOI: 10.1007/s10695-021-01003-x -
American Journal of Obstetrics and... Sep 2018
Topics: Endocrinology; Fertility Agents, Female; History, 20th Century; History, 21st Century; Infertility; Menotropins; Reproductive Medicine
PubMed: 30170793
DOI: 10.1016/j.ajog.2018.06.019 -
American Journal of Obstetrics and... Jun 1997Our purpose was to determine whether aortic size and compliance are altered by an exogenously induced rise in estrogen. (Clinical Trial)
Clinical Trial
OBJECTIVE
Our purpose was to determine whether aortic size and compliance are altered by an exogenously induced rise in estrogen.
STUDY DESIGN
Magnetic resonance imaging was used to determine the aortic cross-sectional area/aortic pressure relationship in nine premenopausal women before and after menotropin therapy. Simultaneous electrocardiograms, carotid pulse tracings, phonocardiograms, and brachial artery pressures were obtained before each magnetic resonance imaging acquisition. Ascending thoracic aorta cross-sectional area was obtained every 32 msec and aligned with brachial artery pressures extrapolated from the carotid pulse tracing, allowing construction of the ascending thoracic aorta cross-sectional area/aortic pressure relationships. Aortic cross-sectional area was normalized to body surface area, and the shifts in the position for the ascending thoracic aorta cross-sectional area/aortic pressure relationship were determined with use of analysis of covariance.
RESULTS
Heart rate and aortic pressure were unchanged before and after menotropin treatment. Initial estradiol levels were < 20 pg/ml. After menotropin treatment (7.4 +/- 1.0 days) estradiol levels rose to 905 +/- 371 pg/ml (p < 0.0001). Ascending thoracic aorta cross-sectional area/body surface area was not significantly increased, adjusted y mean of 389 +/- 7 mm2/m2 before and 403 +/- 7 mm2/m2 after menotropin treatment (p < 0.24). The slope of the ascending aorta cross-sectional area/aortic pressure relationship, an index of aortic compliance, increased from 1.4 +/- 0.6 mm2/m2/mm Hg before to 1.7 +/- 0.6 mm2/m2/mm Hg after menotropin treatment (p < 0.001).
CONCLUSION
In premenopausal women a short-term rise in estrogen induced by menotropin treatment is associated with an increase in aortic compliance. Aorta size is not significantly increased within this time frame.
Topics: Adult; Analysis of Variance; Aorta, Thoracic; Blood Pressure; Body Weight; Compliance; Estrogens; Female; Heart Rate; Humans; Linear Models; Magnetic Resonance Imaging; Menotropins; Middle Aged; Premenopause; Vascular Resistance
PubMed: 9215182
DOI: 10.1016/s0002-9378(97)70343-0 -
European Journal of Obstetrics,... May 1980Five quintuplet pregnancies, following induction of ovulation with clomiphene and HMG-HCG, are the subject of this communication. In 3 women, pregnancy was associated...
Five quintuplet pregnancies, following induction of ovulation with clomiphene and HMG-HCG, are the subject of this communication. In 3 women, pregnancy was associated with ovarian overstimulation, and two patients required emergency surgery because of torsion of an ovarian cyst. Two women aborted in mid-trimester, while the other 3 delivered by cesarean section at 33-35 wk gestation. 15 babies were born, weighing 700-2200 g. 8 infants suffered from respiratory distress syndrome and 5 babies were born with correctable malformations. 13 newborns survived, and all are mentally and physically well-developed. Four of the 5 women conceived again. The management of the patients during multiple gestation and the outcome of pregnancy are discussed.
Topics: Clomiphene; Female; Gonadotropins, Pituitary; Humans; Infant, Newborn; Infant, Newborn, Diseases; Menotropins; Ovulation; Ovulation Induction; Pregnancy; Pregnancy Maintenance; Pregnancy, Multiple; Quintuplets; Sex Ratio
PubMed: 6769719
DOI: 10.1016/0028-2243(80)90006-4 -
Fertility and Sterility Sep 1982
Topics: Adult; Coitus; Ethinyl Estradiol; Female; Humans; Infertility, Female; Menotropins
PubMed: 6811335
DOI: 10.1016/s0015-0282(16)46530-1 -
Human Reproduction (Oxford, England) May 1996
Topics: Chorionic Gonadotropin; Female; Fertilization in Vitro; Follicle Stimulating Hormone; Humans; Menotropins; Ovulation Induction
PubMed: 8671358
DOI: 10.1093/oxfordjournals.humrep.a019317 -
The Cochrane Database of Systematic... Apr 1996Both human menopausal gonadotropin (hMG) and human follicle stimulating hormone (hFSH) have been used successfully for ovarian stimulation, but the relative importance... (Review)
Review
BACKGROUND
Both human menopausal gonadotropin (hMG) and human follicle stimulating hormone (hFSH) have been used successfully for ovarian stimulation, but the relative importance of FSH and luteinizing hormone (LH) in follicular growth and maturation has been the subject of much debate.
OBJECTIVES
To conduct a systematic overview of available data comparing FSH and hMG in IVF treatment cycles.
SEARCH STRATEGY
This review has drawn on the search strategy developed for the Menstrual Disorders & Subfertility Group as a whole. Relevant trials were identified in the Group's Specialised Register of Controlled Trials. See Review Group details for more information.
SELECTION CRITERIA
Randomised controlled trials or quasi randomised controlled trials of ovarian stimulation with either hFSH or hMG, in combination with GnRHa or alone, in IVF treatment cycles.
DATA COLLECTION AND ANALYSIS
Common odds ratios (OR) were calculated after demonstrating homogeneity of treatment effect across all trials.
MAIN OUTCOME MEASURES
Clinical pregnancy rates per cycle started, per cycle reaching oocyte retrieval, and per cycle reaching embryo transfer (ET).
RESULTS
Eight trials met the inclusion criteria. The overall OR in favour of FSH for cycle start, oocyte retrieval, and ET were 1.70 (95% CI, 1.11-2.60), 1.68 (95% CI, 1.10-2.56), and 1.69 (95% CI, 1.10-2.59), respectively.
AUTHORS' CONCLUSIONS
This meta-analysis demonstrates that in IVF cycles the use of FSH is associated with a significantly higher clinical pregnancy rate than hMG.
Topics: Female; Fertilization in Vitro; Follicle Stimulating Hormone; Humans; Menotropins; Ovulation Induction; Pregnancy
PubMed: 17636580
DOI: 10.1002/14651858.CD000061