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 recombinantfollicle-stimulating hormone (r FSH) with respect to clinical outcomes and the development ofovarian 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 womenwith PCOS. Of these, 38 were randomized to receive treatment with hMG and 42 with rFSH usinga long gonadotropin releasing hormone (GnRH) analogue protocol. Outcome measures were cyclecharacteristics, 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) andmetaphase II (MII) oocytes (p=0.003). However, there were no significant differences between thegroups in the number of fertilized oocytes, fertilization rates, top quality embryo counts, and thenumber 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 hMGgroup. 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 inPCOS patients treated with a long GnRH agonist protocol in IVF cycles. hMG stimulation appearsto be associated with a lower rate of OHSS and decreased coasting requirements (RegistrationNumber: NCT01365936).