A PROSPECTIVE RANDOMIZED CLINICAL-TRIAL COMPARING RECOMBINANT FOLLICLE-STIMULATING-HORMONE (PUREGON) AND HUMAN MENOPAUSAL GONADOTROPINS (HUMEGON) IN NON-DOWN-REGULATED IN-VITRO FERTILIZATION PATIENTS

A randomized clinical trial was performed comparing recombinant follic le stimulating hormone (rFSH, Puregon, n = 54) and human menopausal go nadotrophin (HMG, Humegon, n = 35) in infertile women undergoing in-vi tro fertilization without the use of a gonadotrophin-releasing hormone (GnRH) agonist, Most patients had a tubal or idiopathic infertility, the latter always longer than 4 years' duration. Patients with sperm a bnormalities were excluded. None of the between-group differences in t reatment outcome was statistically significant. In the rFSH group, a m ean number of 11.2 oocytes was retrieved compared with 8.3 in the HMG group. Ongoing pregnancy rates per started cycle were higher in the rF SH group (22.2%) than in the HMG group (17.1%), Implantation rates wer e 27.5 % in the rFSH group in comparison with 16.7% in the HMG group. In the rFSH group, a mean total dose of 1410 IU during 6.2 days was ad ministered compared with 1365 IU in 6.0 days in the HMG group. Oestrad iol concentrations on the day of human chorionic gonadotrophin adminis tration were 3889 pmol/l in the rFSH group and 3145 pmol/l in the HMG group. In 15 subjects (rFSH: n = 9, 16.7%; HMG: n = 6, 17.1%) luteiniz ing hormone concentrations higher than 10 IU/l were seen during stimul ation. In two of them, both from the rFSH group, ongoing pregnancies w ere achieved. The results indicate that rFSH (Puregon) is at least as efficacious as HMG and that acceptable pregnancy rates can be achieved without the use of a GnRH agonist.