A randomized assessor-blind trial comparing highly purified hMG and recombinant FSH in a GnRH antagonist cycle with compulsory single-blastocyst transfer

A randomized, assessor-blind, multicenter trial with compulsory single-blastocyst transfer documented that highly purified hMG is noninferior to rFSH regarding ongoing pregnancy in GnRH antagonist cycles.

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Authors

Paul Devroey, M.D., Ph.D., Antonio Pellicer, M.D., Anders Nyboe Andersen, M.D., Joan-Carles Arce, M.D., Ph.D., Menopur in GnRH Antagonist Cycles with Single Embryo Transfer (MEGASET) Trial Group

Volume 97, Issue 3, Pages 561-571

Abstract

Objective:

To compare the efficacy and safety of highly purified menotropin (hphMG) and recombinant FSH (rFSH) for controlled ovarian stimulation in a GnRH antagonist cycle with compulsory single-blastocyst transfer.

Design:

Randomized, open-label, assessor-blind, parallel groups, multicenter, noninferiority trial.

Setting:

Twenty-five infertility centers in seven countries.

Patient(s):

Seven hundred forty-nine women.

Intervention(s):

Controlled ovarian stimulation with hphMG or rFSH in a GnRH antagonist cycle with compulsory single-blastocyst transfer on day 5 in one fresh or subsequent frozen blastocyst replacement in natural cycles initiated within 1 year of each patient’s start of treatment.

Main Outcome Measure(s):

Ongoing pregnancy (primary end point) and live birth rates, as well as pharmacodynamic parameters.

Result(s):

The ongoing pregnancy rate after a fresh cycle was 30% with hphMG versus 27% with rFSH for the per-protocol (PP) population and 29% versus 27% for the intention-to-treat (ITT) population. Noninferiority of hphMG compared to rFSH was established. Considering frozen cycles initiated within 1 year, the cumulative live birth rate for a single stimulation cycle was 40% and 38% for women treated with hphMG and rFSH, respectively (both PP and ITT). Significant differences in pharmacodynamic end points were found between the two gonadotropin preparations.

Conclusion(s):

Highly purified hMG is at least as effective as rFSH in GnRH antagonist cycles with compulsory single-blastocyst transfer.

Clinical Trial Registration Number:

NCT00884221.

Read the full text at: http://www.fertstert.org/article/S0015-0282(11)02868-8/fulltext

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Fertility and Sterility

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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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