Gonal F and Cinal F drugs on infertility treatment in ICSI cycle in Milad Infertility Center

Document Type : Original Article

Authors

1 General practitioner, Maternal & Neonatal Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Obstetrics and Gynecology, Maternal & Neonatal Health Research Center, Faculty of Medicines, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant Professor, Department of Pediatrics Nursing, Nursing and Midwifery Care Research Center, School of Nursing And Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

4 M.Sc. in Midwifery, Maternal & Neonatal Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Professor, Department of Obstetrics and Gynecology, Maternal & Neonatal Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Gonadotropins are the main drugs for ovarian stimulation in assisted reproductive cycles. There are many different types of urine, purified or recombinant gonadotropins. This study was performed aimed to compare the clinical outcomes of two types of recombinant Cinal F gonadotropin Iranian company and Gonal F of foreign company.                                
Methods: This retrospective study was conducted in 2015-2019 on 521 infertile women (263 Cinal F and 258 Gonal F) who were referred to Milad Center affiliated to Mashhad University of Medical Sciences and were candidate for IVF. Clinical Outcomes including number of follicles, number of obtained oocytes, number of metaphase1 and 2 oocytes, number of high-quality embryos, rate of ovarian hyperstimulation syndrome, and positive pregnancy test were compared in Cinal F and Gonal F groups. Data were analyzed by SPSS statistical software (version 23) and Independent t-test and chi-square test. P<0.05 was considered statistically significant.
Results: The incidence of ovarian hyperstimulation syndrome and positive pregnancy test was not significantly different in the two groups (P> 0.05). In the Gonal F group, the percentage of good embryo quality was better than Cinal F group (p = 0.017). The number of total follicles and oocytes, metaphase 1 and 2 oocytes and the number of necrotic and low-quality oocytes, and the number of embryos and frozen embryos were not significantly different (P> 0.05).
Conclusion: In this study, there was no evidence in favor of the difference between cinal and foreign drug in the success rate of assisted reproductive cycles. Regarding to the scarcity and high cost of Gonal F, Cinal can be used with confidence in the IVF cycle.

Keywords

References

  1. Firouzabadi RD, Janati S, Razi MH. The effect of intrauterine human chorionic gonadotropin injection before embryo transfer on the implantation and pregnancy rate in infertile patients: A randomized clinical trial. International Journal of Reproductive Biomedicine 2016; 14(10):657.
  2. Practice Committee of the American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss: a committee opinion. Fertility and sterility 2013; 99(1):63.
  3. Direkvand Moghadam A, Delpisheh A, Sayehmiri K. The prevalence of infertility in Iran, a systematic review. Iran J Obstet Gynecol Infertil 2013; 16(81):1-7.
  4. Oliva A, Spira A, Multigner L. Contribution of environmental factors to the risk of male infertility. Human reproduction 2001; 16(8):1768-76.
  5. Berek JS. Berek and Novak's Gynecology. 16nd New York: Lippincott Williams & Wilkins; 2020.
  6. Taylor HS, Pal L, Seli E. Speroff's Clinical Gynecologic Endocrinology and Infertility. 9nd Lippincott Williams & Wilkins; 2020.
  7. Practice Committee of the American Society for Reproductive Medicine. Gonadotropin preparations: past, present, and future perspectives. Fertility and Sterility 2008; 90(5):S13-20.
  8. Giudice E, Crisci C, Eshkol A, Papoian R. Infertility: composition of commercial gonadotrophin preparations extracted from human post-menopausal urine: characterization of non-gonadotrophin proteins. Human Reproduction 1994; 9(12):2291-9.
  9. Olijve W, de Boer W, Mulders JW, van Wezenbeek PM. Recombinat hormones: Molecular biology and biochemistry of human recombinant follicle stimulating hormone (Puregon®). MHR: Basic science of reproductive medicine 1996; 2(5):371-82.
  10. van Wely M, Kwan I, Burt AL, Thomas J, Vail A, Van der Veen F, et al. Recombinant versus urinary gonadotrophin for ovarian stimulation in assisted reproductive technology cycles. Cochrane Database of Systematic Reviews 2011(2).
  11. Weiss NS, Kostova E, Nahuis M, Mol BW, van der Veen F, van Wely M. Gonadotrophins for ovulation induction in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews 2019(1).
  12. Lehert P, Schertz JC, Ezcurra D. Recombinant human follicle-stimulating hormone produces more oocytes with a lower total dose per cycle in assisted reproductive technologies compared with highly purified human menopausal gonadotrophin: a meta-analysis. Reproductive biology and endocrinology 2010; 8(1):1-2.
  13. European Medicines Agency. GONAL-f. (2018). Available online at: https:// www.ema.europa.eu/en/medicines/human/EPAR/gonal-f (accessed January 29, 2019).
  14. Merck Sharp Dohme Limited. Elonva (2019) Available online at: https:// www.ema.europa.eu/en/medicines/human/EPAR/elonva (accessed March 26, 2019).
  15. EMD Serono I. Gonal-F. (2018). Available online at: https://www.drugs.com/ pro/gonal-f.html (accessed 2019 26 Mar).
  16. CinnaGen Co. in 1994 Available online at: https://www.cinnagen.com/Product.aspx??t=2&l=3&Id=166&f=3
  17. Lunenfeld B. Historical perspectives in gonadotrophin therapy. Human reproduction update 2004; 10(6):453-67.
  18. Casper RF. Are recombinant gonadotrophins safer, purer and more effective than urinary gonadotrophins?. Reproductive biomedicine online 2005; 11(5):539-40.
  19. Leão RB, Esteves SC. Gonadotropin therapy in assisted reproduction: an evolutionary perspective from biologics to biotech. Clinics 2014; 69:279-93.
  20. Bordewijk EM, Mol F, van der Veen F, Van Wely M. Required amount of rFSH, HP-hMG and HP-FSH to reach a live birth: a systematic review and meta-analysis. Human reproduction open 2019; 2019(3):hoz008.
  21. Bühler KF, Fischer R, Verpillat P, Allignol A, Guedes S, Boutmy E, et al. Comparative effectiveness of recombinant human follicle-stimulating hormone alfa (r-hFSH-alfa) versus highly purified urinary human menopausal gonadotropin (hMG HP) in assisted reproductive technology (ART) treatments: a non-interventional study in Germany. Reproductive Biology and Endocrinology 2021; 19(1):1-14.
  22. Pan W, Tu H, Jin L, Hu C, Xiong J, Pan W, et al. Comparison of recombinant and urinary follicle-stimulating hormones over 2000 gonadotropin-releasing hormone antagonist cycles: a retrospective study. Scientific reports 2019; 9(1):1-9.
  23. Lunenfeld B, Bilger W, Longobardi S, Kirsten J, D’Hooghe T, Sunkara SK. Decision points for individualized hormonal stimulation with recombinant gonadotropins for treatment of women with infertility. Gynecological Endocrinology 2019; 35(12):1027-36.
  24. Mol BW, Bossuyt PM, Sunkara SK, Velasco JA, Venetis C, Sakkas D, et al. Personalized ovarian stimulation for assisted reproductive technology: study design considerations to move from hype to added value for patients. Fertility and Sterility 2018; 109(6):968-79.
  25. National Institute for Health and Care Excellence. Fertility problems: assessment and treatment (CG156). Available from: https://www.nice.org.uk/ guidance/cg156/chapter/Recommendations. 5
  26. Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, De Mouzon J, Sokol R, et al. The international glossary on infertility and fertility care, 2017. Human reproduction 2017; 32(9):1786-801.
  27. Ghaebi NK, Mahmoudiniya M, Najafi MN, Zohdi E, Attaran M. Comparison of letrozole with gonadotropin-releasing hormone agonist in frozen embryo transfer after recurrent implantation failure: An RCT. International Journal of Reproductive BioMedicine 2020; 18(2):105.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 25, Issue 5
July 2022
Pages 50-57

Files

Share

How to cite

Statistics