Comparing the efficacy of pergoveris with follitropin alfa for ovarian stimulation in patients ≥ 35 years old

Abstract

Introduction: Improving IVF outcomes in patients who are ≥ 35 years old is a challenge for clinicians. LH supplementation in the ovarian stimulation regime could be one strategy; however, it is still very controversial.

Methods: A randomized controlled trial was conducted on 240 patients ≥ 35 years old to compare the clinical pregnancy rate and implantation rate between two groups of patients who had LH supplementation (Pergoveris) and had not LH supplementation (Follitropin alfa, Gonal-F) in the ovarian stimulation regime. Ovarian stimulation was performed by using GnRH antagonist protocol. LH supplementation was done by replacing follitropin alfa by pergoveris from day 6 of stimulation.

Results: There were no significant differences in the number of oocytes retrieved, number of embryos, clinical pregnancy rate and implantation rate between Pergoveris group and Gonal-F group. However, the clinical pregnancy rate in the Pergoveris group tended to be higher when patients were of the poor prognostic groups (25.4% vs. 19.2% in patients of ≥ 38 years, 25% vs. 18.4% in patients with reduced ovarian reserve, 28.6% vs. 8.3% in patients of ≥ 38 years and had reduced ovarian reserve).

Conclusion: No significant differences were found with regard to the ovarian stimulation outcomes and the clinical pregnancy rate between two groups of patients who had and had not LH supplementation. The clinical pregnancy rate tended to be higher in patients with difficult prognosis.