Recombinant FSH Versus Highly Purified Urinary FSH in Patients with Polycystic Ovary Syndrome Undergoing ICSI Cycles: A Prospective Randomized Study

Abstract

Objective: To compare efficacy and safety of recombinant follicule stimulating hormone (r-FSH) and highly purified urinary FSH (HPuFSH) in polycystic ovary syndrome (PCOS) patients undergoing intracytoplasmic sperm injection (ICSI). Method: This was a prospective randomized study conducted at Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology, in vitro fertizilization (IVF) Unit. A total of 91 PCOS patients undergoing ICSI were randomly assigned to receive either r-FSH (n=46) or HPuFSH (n=45) with a gonadotropin releasing hormone (GnRH) antagonist protocol. The main outcome measures were the number of mature oocytes retrieved, embryo quality, pregnancy rates, implantation rates. Results: The number of mature oocytes retrieved, fertilization rates, the number of cryopreserved embryos were significantly higher in r-FSH group (p=0.024, p=0.023, p=0.026 respectively) while the total dose of FSH used was significantly lower in the same group (p=0.023). Pregnancy rates, clinical pregnancy rates were higher in r-FSH group although not statistically significant (52.2% versus 35.6%, p=0.11, 37% versus 28.9%, p=0.41 respectively). Overall therapy costs per clinical pregnancy were associated with a 9.94% increase in r-FSH group whereas costs per pregnancy were not different between groups. Conclusion: r-FSH is superior than HP-uFSH in PCOS regarding fertilization rates, the number of mature oocytes retrieved and cryopreserved embryos, pregnancy rates although overall therapy costs per clinical pregnancy are higher.