OUTCOME FROM CONSECUTIVE IN-VITRO FERTILIZATION INTRACYTOPLASMIC SPERM INJECTION ATTEMPTS IN THE FINAL GROUP TREATED WITH URINARY GONADOTROPINS AND THE FIRST GROUP TREATED WITH RECOMBINANT FOLLICLE-STIMULATING-HORMONE

In the absence of specific dose equivalency data, the aim of this stud y was to compare the clinical results during the cross-over from menop ausal urinary products (human menopausal gonadotrophin; HMG) to recomb inant follicle stimulating hormone (FSH) follitrophin beta (FSHr) in o rder to determine whether the manufacturer's recommendation for equiva lence of ampoule to ampoule (50 IU FSHr:75 IU HMG) would prove clinica lly correct. A total of 353 consecutive in-vitro fertilization (IVF)/i ntracytoplasmic sperm injection (ICSI) treatment cycles was studied be tween Ist September 1996 and mid-February 1997, This included cycles i n the last 191 women receiving HMG and the first 162 taking FSHr, All were down-regulated using a gonadotrophin releasing hormone (GnRH) ago nist long protocol method from day 1 of the cycle. Greater efficacy wa s seen in the HMG group in terms of days of stimulation required, need to increase dosage, cycle discontinuation, number of follicles punctu red, the numbers of oocytes retrieved and their quality. The hormonal response to stimulation assessed by oestradiol concentrations on days 5, 8 and day of human chorionic gonadotrophin (HCG) was significantly lower in the FSHr group. The ratio of oestradiol per follicle and per oocyte was significantly lower in the FSHr group. There was a highly s ignificant increase in cost with FSHr therapy. Clinical pregnancy rate s were 14% per cycle with FSHr and 20% per cycle with HMG.