Economic evaluation of highly purified human menotropin or recombinant follicle-stimulating hormone for controlled ovarian stimulation in high-responder patients: analysis of the MEGASET-HR trial

Assisted Reproduction

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Authors:

Jared C. Robins, M.D., Andrew F. Khair, Ph.D., M.B.A., Eric A. Widra, M.D., Michael M. Alper, M.D., Winnie W. Nelson, Pharm.D., M.S., M.B.A., Eric D. Foster, Ph.D., Anshul Sinha, B.Tech., Masakazu Ando, Ph.D., Patrick W. Heiser, Ph.D., Gaurang S. Daftary, M.D., M.B.A.

Abstract:

Objective

To determine the cost of achieving a live birth after first transfer using highly purified human menotropin (HP-hMG) or recombinant follicle-stimulating hormone (FSH) for controlled ovarian stimulation in predicted high-responder patients in the Menopur in Gonadotropin-releasing hormone Antagonist Single Embryo Transfer–High Responder (MEGASET-HR) trial.


Design

Cost minimization analysis of trial results.


Setting

Thirty-one fertility centers.


Patient(s)

Six hundred and nineteen women with serum antimüllerian hormone ≥5 ng/mL.


Intervention(s)

Controlled ovarian stimulation with HP-hMG or recombinant FSH in a gonadotropin-releasing hormone (GnRH) antagonist assisted reproduction cycle where fresh transfer of a single blastocyst was performed unless ovarian response was excessive whereupon all embryos were cryopreserved and patients could undergo subsequent frozen blastocyst transfer within 6 months of randomization.


Main Outcome Measure(s)

Mean cost of achieving live birth after first transfer (fresh or frozen).


Result(s)

First-transfer efficacy, defined as live birth after first fresh or frozen transfer, was 54.5% for HP-hMG and 48.0% for recombinant FSH (difference 6.5%). Average cost to achieve a live birth after first transfer (fresh or frozen) was lower with HP-hMG compared with recombinant FSH. For fresh transfers, the cost was lower with HP-hMG compared with recombinant FSH. The average cost to achieve a live birth after first frozen transfer was also lower in patients treated with HP-hMG compared with recombinant FSH.


Conclusion(s)

Treatment of predicted high-responders with HP-hMG was associated with lower cost to achieve a live birth after first transfer compared with recombinant FSH.


Clinical Trial Registration Number

NCT02554279.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

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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