Human Menopausal Gonadotropin versus Recombinant FSH in Polycystic Ovary Syndrome Patients Undergoing In Vitro Fertilization

BACKGROUND: We aimed to compare human menopausal gonadotropin (hMG) and recombinant follicle-stimulating hormone (r FSH) with respect to clinical outcomes and the development of ovarian hyperstimulation syndrome (OHSS) for patients with polycystic ovary syndrome (PCOS) treated with in vitro fertilization (IVF). MATERIALS AND METHODS: This prospective randomized controlled trial included a total of 80 women with PCOS. Of these, 38 were randomized to receive treatment with hMG and 42 with rFSH using a long gonadotropin releasing hormone (GnRH) analogue protocol. Outcome measures were cycle characteristics, pregnancy rates, the need for coasting, and OHSS rates. RESULTS: In the hMG group we observed a significantly lower peak estradiol (E2) level (p=0.02), fewer intermediate-sized follicles (p=0.001), lower number of oocytes retrieved (p=0.002) and metaphase II (MII) oocytes (p=0.003). However, there were no significant differences between the groups in the number of fertilized oocytes, fertilization rates, top quality embryo counts, and the number of transferred embryos. There was no difference in pregnancy rates between the groups. OHSS occurred in 11.9% of the rFSH group patients, whereas no OHSS developed in the hMG group. Coasting requirements were lower in the hMG group (19.2% vs. 48.9%, p=0.013). CONCLUSION: Ovarian stimulation with hMG and rFSH provides similar clinical pregnancy rates in PCOS patients treated with a long GnRH agonist protocol in IVF cycles. hMG stimulation appears to be associated with a lower rate of OHSS and decreased coasting requirements (Registration Number: NCT01365936).