SUPEROVULATION BEFORE IVF BY RECOMBINANT VERSUS URINARY HUMAN FSH (COMBINED WITH A LONG GNRH ANALOG PROTOCOL) - A COMPARATIVE-STUDY

被引:23
作者
FISCH, B
AVRECH, OM
PINKAS, H
NERI, A
RUFAS, O
OVADIA, J
LOUMAYE, E
机构
[1] Infertility and IVF Unit, Department of Obstetrics and Gynecology, Beilinson Medical Center, Petah-Tikva
[2] Sackler Faculty of Medicine, Tel-Aviv University, Peta-Tikva
[3] Serono Labs Inc., Aubonne
关键词
RECOMBINANT HUMAN FSH; URINARY HUMAN FSH; IVF; CONTROLLED OVARIAN HYPERSTIMULATION;
D O I
10.1007/BF02214125
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Purpose: Gonal-F (Serono, Aubonne, Switzerland) is a recombinant human follicle stimulating hormone (FSH) synthesized in vitro by cells into which genes encoding for FSH subunits have been inserted. This preparation exhibits physiochemical, immunological, and pharmacological properties that bear great similarity to those of native human FSH. It has a high specific activity and can be administered subcutaneously. To compare the efficacy and safety of Gonal-F with those of urinary human FSH (Metrodin; Serono) in achieving superovulation far IVF purposes in a prospective, randomized study. Methods: Twenty infertile patients (normo-ovulatory healthy women) were recruited for the study and allocated at random to the Gonal-F or Metrodin groups. The treatment protocol consisted of pituitary down regulation by GnRH analog (Buserelin; Hoechst, Frankfurt, Germany) employing the ''long'' protocol initiated at the mid-luteal phase (900 mu g/day, intranasal administration). Gonal-F (SC) or Metrodin (IM) was injected daily (225 IU/day) starting on cycle day 3. Dose adjustment was performed, when necessary, from cycle day 7. Results: Of the 20 cycles analyzed, none was canceled due to poor response. No cases of adverse effects (including local intolerance) or ovarian hyperstimulation syndrome were recorded in either group. They did not differ significantly in the following treatment-dependent variables: hormone profile, duration of FSH treatment, total FSH dose required to achieve follicular maturation, and the number of oocytes retrieved, fertilized, and replaced. Conclusions: These preliminary data concur with previous studies in demonstrating that Gonal-F is as effective and safe as Metrodin (when given in combination with a ''long'' protocol of GnRH analog) in inducing controlled ovarian hyperstimulation for IVF purposes. Its mode of administration (SC instead of IM) offers an additional advantage over the urinary human FSH.
引用
收藏
页码:26 / 31
页数:6
相关论文
共 27 条
[1]  
Jones G.S., Acosta A.A., Garcia J.E., Bernardus R.E., Rosenwaks Z., The effect of follicle-stimulating hormone without additional luteinizing hormone on follicular stimulation and oocyte development in normal ovulatory women, Fertil Steril, 43, pp. 696-702, (1985)
[2]  
Stanger J.D., Yovich J.L., Reduced in vitro fertilization of human oocytes from patients with raised basal luteinizing hormone levels during the follicular phase, Br J Obstet Gynaecol, 92, pp. 385-392, (1985)
[3]  
Punnonen R., Ashorn R., Vilja P., Heinonen P.K., Kujansuu E., Spontaneous luteinizing hormone surge and cleavage of in vitro fertilized embryos, Fertil Steril, 49, pp. 479-482, (1988)
[4]  
Homburg R., Armar N.A., Eshel A., Ada J., Jacobs H.S., Influence of serum luteinizing hormone concentrations on ovulation, conception and early pregnancy loss in polycystic ovarian syndrome, BMJ, 297, pp. 1024-1026, (1988)
[5]  
Fisch B., Kaplan-Kraicer R., Amit S., Zukerman Z., Ovadia J., Tadir Y., The relationship between sperm parameters and fertilizing capacity in vitro: a predictive role for swim-up migration, J in Vitro Fertil Embryo Transfer, 7, pp. 38-44, (1990)
[6]  
Lunenfeld B., Sulimovici S., Rabau E., Eshkol A., L'induction de l'ovulation dans les amenorrhees hypophysaires par un traitement combine de gonadotrophines urinaries menopausiques et de gonadotrophines chorioniques, Comptes rendus de la Societe Franciase de Gynecologie, 5, pp. 30-34, (1962)
[7]  
Li T.C., Hindle J.E., Adverse local reaction to intramuscular injections of urinary derived gonadotrophins, Hum Reprod, 8, pp. 1835-1836, (1993)
[8]  
Chappel S., Kelton C., Nugent N., Expression of human gonadotropins by recombinant DNA methods, Proceedings of the 3rd World Congress on Gynecological Endocrinology, pp. 179-184, (1992)
[9]  
Cerpa Poljak A., Bishop L.A., Hort Y.J., Chin C.K., DeKroon R., Mahler S.M., Smith G.M., Stuart M.C., Schofield P.R., Isoelectric charge of recombinant human follicle stimulating hormone isoforms determines receptor affinity and in vitro bioactivity, Endocrinology, 132, pp. 351-356, (1993)
[10]  
Galway A.B., Hsueh A.J., Keene J.L., Yamato M., Fauser B.C., Boime I., In vitro and in vivo bioactivity of recombinant human follicle stimulating hormone and partially deglycosylated variants secreted by transfected eukaryotic cell lines, Endocrinology, 127, pp. 93-100, (1990)