Stanwell Road, Feltham, Middlesex TW14 8NX, UK e-mail: amirlass{at}yahoo.com
Dear Sir,
I read the recent article by van Wely et al. (2003) with great interest. In their meta-analysis, the authors found and included three studies comparing recombinant FSH (rFSH) with urinary-derived FSH (uFSH) (Loumaye et al., 1996
; Coelingh Bennink et al., 1998
; Yarali et al., 1999
). To the best of my knowledge, there is no published study directly comparing rFSH with HMG in ovulation induction in general, and in polycystic ovary patients in particular. Therefore, the title Recombinant FSH in alternative doses or versus urinary gonadotrophins... may confuse the reader, who assumes that rFSH was evaluated against urinary gonadotrophins or HMG. The true comparison of rFSH versus uFSH was clarified in the abstract and the article, but not in the title. I think it is relevant and important to clarify this point so as not to mislead the casual reader with the all encompassing term urinary gonadotrophins when the more specific term urinary FSH is more appropriate.
References
Coelingh Bennink HJ, Fauser BC and Out HJ (1998) Recombinant follicle-stimulating hormone (FSH; Puregon) is more efficient than urinary FSH (Metrodin) in women with clomiphene citrate-resistant, normogonadotropic, chronic anovulation: a prospective, multicenter, assessor-blind, randomized, clinical trial. European Puregon Collaborative Anovulation Study Group. Fertil Steril 69,1925.[CrossRef][ISI][Medline]
Loumaye E, Martineau I, Piazzi A, ODea L, Ince S, Howles C, Decosterd G, Van Loon K and Galazka A (1996) Clinical assessment of human gonadotrophins produced by recombinant DNA technology. Hum Reprod 11,95107.[Abstract]
van Wely M, Bayram N and van der Veen F (2003) Recombinant FSH in alternative doses or versus urinary gonadotrophins for ovulation induction in subfertility associated with polycystic ovary syndrome: a systematic review based on a Cochrane review. Hum Reprod 18,11431149.
Yarali H, Bukulmez O and Gurgan T (1999) Urinary follicle-stimulating hormone (FSH) versus recombinant FSH in clomiphene citrate-resistant, normogonadotropic, chronic anovulation: a prospective randomized study. Fertil Steril 72,276281.[CrossRef][ISI][Medline]