Comparison of the efficacy and cost-effectiveness of highly purified urinary follicle stimulating hormone [HP-uFSH] and recombinant follicle stimulating hormone [rFSH] in Poor Responders

ABSTRACT

We aimed to compare the clinical results and effectiveness of two gonadothropin treatment protocols; HP-uFSH and rFSH in poor responders. While HP-uFSH was given to 58 patients, rFSH was given to 62 patients. The patient selection criteria were the same [FSH value>15 iu/l or antral follicle number<4, on the second day of menstruation]. Endometrial thickness on hCG day [mm] was 9.0 +/- 2.7 and 7.8 +/- 2.7 in HP-uFSH group and rFSH group, respectively and this difference was statistically significant. Contrarily, fertilization rate [%] was better in rFSH than HP-uFSH [76.6 +/- 15.9 vs. 68.2 +/- 17.8] and this value was also statistically significant. Percentage of cancelled cycles [%] was 14 +/- 34 in HP-uFSH group and this parameter was significantly lower than rFSH group [29 +/- 45]. rFSH is as efficacious as HP-uFSH in poor responders. Fertilization rate was better in rFSH than HP-uFSH. Since rFSH is more expensive, the final treatment cost with rFSH to obtain a pregnancy was slightly higher, but this difference was not statistically significant [20060 TL vs. 17150 TL]