Follicle-stimulating hormone and human menopausal gonadotropin for ovarian stimulation in assisted reproduction cycles
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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.
