Comparison of ART Outcomes between Two COH Protocols: Gonal-F versus Gonal-F Plus HMG

The purpose of this prospective, randomized study was to compare ovarian response as well as oocytes, embryo yields and pregnancy rates in women who underwent ovulation induction for intracytoplasmic sperm injection (ICSI) with recombinant human FSH (rFSH) alone or in combination with human menopausal gonadotropin (HMG). Out of 300 patients in assisted reproductive technique (ART) cycles who underwent down regulation with GnRH analogue in a long protocol, 64 patients received 150 IU/d r FSH until day six when they were randomly allocated into two study groups: group A, who received rFSH alone (n=32) and group B, (n= 32) who received rFSH and HMG. The total number of ampoules of rFSH, the numbers of oocytes retrieved, embryos and serum concentrations of luteinizing hormone (LH) on the day of hCG administration were similar in both treatment groups. However, the numbers of follicles ≥15mm, serum concentrations of progesterone and estradiol on the day of hCG administration were significantly higher in group B when compared to group A. Although the number of high quality embryos (grades A and B) were significantly better in group B, the number of pregnancies and live birth rates were similar in both groups. The study shows that the addition of LH to rFSH in pituitary – suppressed women undergoing ART improves some parameters of ovarian response, but doesn’t improve overall pregnancy rates.