Meta-analysis of recombinant FSH and urinary-derived gonadotrophins for IVF or ICSI

Hesham Al-Inany

The Egyptian IVF-ET Center, 3 Street 161, Hadayek El-Maadi, Cairo 11431, Egypt e-mail: ivf{at}link.net

Dear Sir,

We would like to thank Drs van Wely and van der Veen for their interest in our meta-analysis and their support of the concept of data analysis. We totally agree with them that live birth rate is the ultimate success that should be applied when evaluating infertility treatment modalities and this was mentioned in the discussion section; however, the pregnancy outcome was not reported in all the studies included in our meta-analysis and that is why the clinical pregnancy rate was used as the endpoint in our study.

In response to the comments, we analysed the live birth/ongoing pregnancy data available in the studies included in our meta-analysis. The overall conclusion is that there is no statistically significant difference between recombinant (r)FSH and urinary gonadotrophins regarding live birth/ongoing pregnancy rate [OR 1.06 (95% CI 0.91–1.23)] (Figure 1). Calculating miscarriage rate has also showed no statistically significant difference between rFSH and urinary gonadotrophins [OR 0.89 (95% CI 0.65–1.22)]. (Figure 2).



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Figure 1. Comparison between rFSH and urinary gonadotrophins (hMG, FSH-P, FSH-HP).

 


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Figure 2. Comparison between rFSH and urinary gonadotrophins regarding miscarriage rate.

 
In addition, recalculating the clinical pregnancy rate per cycle started after extracting the correct data from the paper of The European and Israeli Study Group on highly purified hMG versus rFSH (2002)Go would result in OR 95% CI that reached unity, meaning that there is no statistically significant difference between both types of gonadotrophins [OR 0.78 (95% CI 0.61–1.00)]

References

The European and Israeli Study Group on highly purified hMG versus rFSH (2002) Efficacy and safety of highly purified menotropin versus recombinant follicle-stimulating hormone in in vitro fertilization/intracytoplasmic sperm injection cycles: a randomized, comparative trial. Fertil. Steril., 78, 520–528.[CrossRef][ISI][Medline]





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