Bye-bye urinary gonadotrophins? Recombinant FSH: A real progress in ovulation induction and IVF?
Whether recombinant gonadotrophin products do, indeed, represent progress for routine ovulation induction and IVF cycles, in comparison with urinary products, has remained controversial. Here we review published data with regard to respective risks, outcomes and cost for both medication options. Saf...
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| Veröffentlicht in: | Human reproduction (Oxford) 2003-03, Vol.18 (3), p.476-482 |
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| creator | GLEICHER, Norbert VIETZKE, Mary VIDALI, Andrea |
| description | Whether recombinant gonadotrophin products do, indeed, represent progress for routine ovulation induction and IVF cycles, in comparison with urinary products, has remained controversial. Here we review published data with regard to respective risks, outcomes and cost for both medication options. Safety considerations favour recombinant products, while overall outcome and cost considerations favour urinary gonadotrophins. Outcome, however, appears to differ, based on age and ovarian function, with younger patients benefiting from the FSH/LH combination offered by urinary products, while older women and young women with ovarian resistance, apparently benefiting from pure FSH stimulation. Young women with poor ovarian reserve may be best stimulated with a pure FSH/antagonist protocol. We conclude that under current pricing structures in the United States, recombinant gonadotrophins do not represent a major progress for the treatments of ovulation induction and IVF. They, however, allow for an improved selectivity of stimulation protocols. The creation of recombinant FSH/LH products and cost adjustments for recombinant products, may affect these conclusions in favour of recombinant products. |
| doi_str_mv | 10.1093/humrep/deg099 |
| format | Article |
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Recombinant FSH: A real progress in ovulation induction and IVF?</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>GLEICHER, Norbert ; VIETZKE, Mary ; VIDALI, Andrea</creator><creatorcontrib>GLEICHER, Norbert ; VIETZKE, Mary ; VIDALI, Andrea</creatorcontrib><description>Whether recombinant gonadotrophin products do, indeed, represent progress for routine ovulation induction and IVF cycles, in comparison with urinary products, has remained controversial. Here we review published data with regard to respective risks, outcomes and cost for both medication options. Safety considerations favour recombinant products, while overall outcome and cost considerations favour urinary gonadotrophins. Outcome, however, appears to differ, based on age and ovarian function, with younger patients benefiting from the FSH/LH combination offered by urinary products, while older women and young women with ovarian resistance, apparently benefiting from pure FSH stimulation. Young women with poor ovarian reserve may be best stimulated with a pure FSH/antagonist protocol. We conclude that under current pricing structures in the United States, recombinant gonadotrophins do not represent a major progress for the treatments of ovulation induction and IVF. They, however, allow for an improved selectivity of stimulation protocols. 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Obstetrics ; Humans ; Medical sciences ; Models, Biological ; Ovulation Induction - economics ; Ovulation Induction - methods ; Recombinant Proteins - adverse effects ; Recombinant Proteins - economics ; Recombinant Proteins - therapeutic use ; Sterility. 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Recombinant FSH: A real progress in ovulation induction and IVF?</title><title>Human reproduction (Oxford)</title><addtitle>Hum Reprod</addtitle><description>Whether recombinant gonadotrophin products do, indeed, represent progress for routine ovulation induction and IVF cycles, in comparison with urinary products, has remained controversial. Here we review published data with regard to respective risks, outcomes and cost for both medication options. Safety considerations favour recombinant products, while overall outcome and cost considerations favour urinary gonadotrophins. Outcome, however, appears to differ, based on age and ovarian function, with younger patients benefiting from the FSH/LH combination offered by urinary products, while older women and young women with ovarian resistance, apparently benefiting from pure FSH stimulation. Young women with poor ovarian reserve may be best stimulated with a pure FSH/antagonist protocol. We conclude that under current pricing structures in the United States, recombinant gonadotrophins do not represent a major progress for the treatments of ovulation induction and IVF. They, however, allow for an improved selectivity of stimulation protocols. The creation of recombinant FSH/LH products and cost adjustments for recombinant products, may affect these conclusions in favour of recombinant products.</description><subject>Biological and medical sciences</subject><subject>Birth control</subject><subject>Drug Costs</subject><subject>Female</subject><subject>Fertilization in Vitro - methods</subject><subject>Follicle Stimulating Hormone - therapeutic use</subject><subject>Gonadotropins - adverse effects</subject><subject>Gonadotropins - economics</subject><subject>Gonadotropins - therapeutic use</subject><subject>Gonadotropins - urine</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Models, Biological</subject><subject>Ovulation Induction - economics</subject><subject>Ovulation Induction - methods</subject><subject>Recombinant Proteins - adverse effects</subject><subject>Recombinant Proteins - economics</subject><subject>Recombinant Proteins - therapeutic use</subject><subject>Sterility. 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Recombinant FSH: A real progress in ovulation induction and IVF?</title><author>GLEICHER, Norbert ; VIETZKE, Mary ; VIDALI, Andrea</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c385t-969c9902c4c631f2f8228d5f3815e248e20fba178278eb41f9c6ee1eb3df0c1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Biological and medical sciences</topic><topic>Birth control</topic><topic>Drug Costs</topic><topic>Female</topic><topic>Fertilization in Vitro - methods</topic><topic>Follicle Stimulating Hormone - therapeutic use</topic><topic>Gonadotropins - adverse effects</topic><topic>Gonadotropins - economics</topic><topic>Gonadotropins - therapeutic use</topic><topic>Gonadotropins - urine</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Models, Biological</topic><topic>Ovulation Induction - economics</topic><topic>Ovulation Induction - methods</topic><topic>Recombinant Proteins - adverse effects</topic><topic>Recombinant Proteins - economics</topic><topic>Recombinant Proteins - therapeutic use</topic><topic>Sterility. Assisted procreation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GLEICHER, Norbert</creatorcontrib><creatorcontrib>VIETZKE, Mary</creatorcontrib><creatorcontrib>VIDALI, Andrea</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Nucleic Acids Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Human reproduction (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GLEICHER, Norbert</au><au>VIETZKE, Mary</au><au>VIDALI, Andrea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bye-bye urinary gonadotrophins? Recombinant FSH: A real progress in ovulation induction and IVF?</atitle><jtitle>Human reproduction (Oxford)</jtitle><addtitle>Hum Reprod</addtitle><date>2003-03-01</date><risdate>2003</risdate><volume>18</volume><issue>3</issue><spage>476</spage><epage>482</epage><pages>476-482</pages><issn>0268-1161</issn><issn>1460-2350</issn><eissn>1460-2350</eissn><coden>HUREEE</coden><abstract>Whether recombinant gonadotrophin products do, indeed, represent progress for routine ovulation induction and IVF cycles, in comparison with urinary products, has remained controversial. Here we review published data with regard to respective risks, outcomes and cost for both medication options. Safety considerations favour recombinant products, while overall outcome and cost considerations favour urinary gonadotrophins. Outcome, however, appears to differ, based on age and ovarian function, with younger patients benefiting from the FSH/LH combination offered by urinary products, while older women and young women with ovarian resistance, apparently benefiting from pure FSH stimulation. Young women with poor ovarian reserve may be best stimulated with a pure FSH/antagonist protocol. We conclude that under current pricing structures in the United States, recombinant gonadotrophins do not represent a major progress for the treatments of ovulation induction and IVF. They, however, allow for an improved selectivity of stimulation protocols. The creation of recombinant FSH/LH products and cost adjustments for recombinant products, may affect these conclusions in favour of recombinant products.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>12615810</pmid><doi>10.1093/humrep/deg099</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Biological and medical sciences Birth control Drug Costs Female Fertilization in Vitro - methods Follicle Stimulating Hormone - therapeutic use Gonadotropins - adverse effects Gonadotropins - economics Gonadotropins - therapeutic use Gonadotropins - urine Gynecology. Andrology. Obstetrics Humans Medical sciences Models, Biological Ovulation Induction - economics Ovulation Induction - methods Recombinant Proteins - adverse effects Recombinant Proteins - economics Recombinant Proteins - therapeutic use Sterility. Assisted procreation Treatment Outcome |
| title | Bye-bye urinary gonadotrophins? Recombinant FSH: A real progress in ovulation induction and IVF? |
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