Does the Type of Gonadotropins Affect Assisted Reproductive Technology Outcomes? A Retrospective Cohort Study

ReseaRch aRticlerates. 2 While other studies suggest that rFSH may enhance oocyte yield and embryo development.3,4 Overall, large RCTs and metaanalyses of both agonist and antagonist protocols comparing rFSH and hMG for ovarian stimulation show largely comparable outcomes in terms of live birth and clinical pregnancy.[5][6][7][8] Collectively, these findings support the concept that hMG is noninferior to rFSH and may offer additional benefits in selected patient populations, such as IntroductIonControlled ovarian stimulation (COS) is a foundation of in vitro fertilization (IVF), and the selection of the gonadotropin regimen plays an important role in determining cycle success.Currently, recombinant follicle-stimulating hormone (rFSH), a pure recombinant DNA-derived product containing only FSH activity, and human menopausal gonadotropin (hMG), a urinary-derived preparation containing both FSH and luteinizing hormone (LH) activity are the two types of gonadotropin most commonly used for COS. 1 The combination of rFSH with hMG has gained increasing attention as a cost-effective alternative to recombinant LH (rLH), the use of which remains limited in routine clinical practice due to its higher cost and restricted availability.Although FSH alone is sufficient to induce multifollicular development and achieve oocyte maturation in IVF cycles, the profound suppression of endogenous LH observed in modern stimulation protocols has raised questions regarding the potential benefits of exogenous LH supplementation.This uncertainty is reflected in the ongoing discussion regarding the most appropriate type of exogenous gonadotropin for optimizing IVF outcomes.Several studies suggest that ovarian stimulation with hMG improves oocyte and embryo quality with higher implantation and pregnancy 1-