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Evidence of clinical superioriy

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Evidence of clinical superioriy

  1. 1. Evidence of Clinical Superioriy From hMG to HP-hMG
  2. 2. IVF/ICSI cycles • Multifollicular development by gonadotrophins is still an integral component for ovarian stimulation in IVF / ICSI cycles (Keck et al, 2005)
  3. 3. In The Market VS hMG rec FSH
  4. 4. !! • In the 1990s, recombinant FSH was not directly compared to hMG • It was compared to HP-FSH
  5. 5. • the relatively high price of rFSH has hampered its wide-spread clinical use (Sykes et al., 2001).
  6. 6. Gonadotrophins • The technological developments of gonadotrophins over the last years have shown improvements in specific activity, purity, degradation and impurities (Bassett & Driebergen, 2005)
  7. 7. In the new millennium  There was no significant difference between hMG & recFSH regarding clinical pregnancy rate Al-Inany et al, 2005
  8. 8. Al-Inany et al., RBM Online, (2008) Live birth rate hMG (363/ 1453) vs. rFSH (324/ 1484) (O.R = 1.20, 95% CI = 1.01 - 1.42; P < 0.04)
  9. 9. Observation • More than 2/3 of participants in hMG arm in our meta-analysis used HP- hMG which could be the influencing factor to change the evidence Al-Inany et al., RBM Online, 2008
  10. 10. Clinical Pregnancy Rate HP-hMG (320/ 1176) vs. rFSH (279/ 1178) ( O.R = 1.21, 95% CI = 1.00 - 1.45) (P = 0.05)
  11. 11. Ongoing Pregnancy/ Live-birth Rate HP-hMG (293/ 1176) vs. rFSH (258/ 1178) 24.9% vs 21.9% ( O.R = 1.19, 95% CI = 0.98 - 1.44) (P = 0.08)
  12. 12. HP-hMG is preferred in IVF cycles due to better live birth rate

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