Recombinant Follitropin Alfa/lutropin Alfa in Fertility Treatment

Overview

Journal Biologics

Date 2010 Feb 18

PMID 20161981

Citations 5

Authors

Ahmed Gibreel

Siladitya Bhattacharya

Affiliations

Soon will be listed here.

Abstract

Recombinant human follicle stimulating hormone (rFSH) and luteinizing hormone (LH), also known as follitropin alpha and lutropin alpha, are manufactured by genetic engineering techniques which ensure high quality and batch to batch consistency. Follitropin alpha can be used for controlled ovarian hyperstimulation in assisted reproduction, ovulation induction for WHO group I and II anovulatory infertility and in men with hypogonadotrophic hypogonadism (HH) or idiopathic oligo-asthenospermia. Current evidence suggests superiority of urinary human menopausal gonadotropin (HMG) over follitropin alpha in controlled ovarian hyperstimulation for IVF in terms of live birth rate per couple. Addition of lutropin to follitropin alpha in an unselected IVF population does not appear to confer any benefit; however, it may have a role in ovulation induction in women with hypothalamic hypogonadism. Urinary HMG preparations (especially currently available highly purified preparations) are more cost effective than rFSH in terms of cost per ongoing pregnancy. However, women using rFSH injection pen devices have higher levels of satisfaction as compared to those using urinary HMG by means of conventional syringes.

Citing Articles

Editorial: Functional hypothalamic amenorrhea seen from different perspectives.

Garzia E, Marconi A, Lania A, Miozzo M, Vegni E, Priori A Front Endocrinol (Lausanne). 2023; 14:1167668.

PMID: 37091851 PMC: 10117907. DOI: 10.3389/fendo.2023.1167668.

Luteinizing hormone supplementation in women with hypogonadotropic hypogonadism seeking fertility care: Insights from a narrative review.

Di Segni N, Busnelli A, Secchi M, Cirillo F, Levi-Setti P Front Endocrinol (Lausanne). 2022; 13:907249.

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Controlled ovarian stimulation therapy as a potential risk for the development and progression of renal cell carcinomas: A case report and literature review.

Doukas S, Martinez B, Rosenthal M, Vageli D Mol Clin Oncol. 2021; 15(1):140.

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Safety of Follitropin Alfa/Lutropin Alfa for Stimulation of Follicular Development.

Abramova N, Hubbard J, Schertz J, Richter E Drug Saf. 2018; 42(3):453-461.

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Profile of follitropin alpha/lutropin alpha combination for the stimulation of follicular development in women with severe luteinizing hormone and follicle-stimulating hormone deficiency.

Rinaldi L, Selman H Int J Womens Health. 2016; 8:169-79.

PMID: 27307766 PMC: 4888763. DOI: 10.2147/IJWH.S88904.

References

Kliesch S, Behre H, Nieschlag E . Recombinant human follicle-stimulating hormone and human chorionic gonadotropin for induction of spermatogenesis in a hypogonadotropic male. Fertil Steril. 1995; 63(6):1326-8. DOI: 10.1016/s0015-0282(16)57619-5. View

Gerli S, Casini M, Unfer V, Costabile L, Bini V, Di Renzo G . Recombinant versus urinary follicle-stimulating hormone in intrauterine insemination cycles: a prospective, randomized analysis of cost effectiveness. Fertil Steril. 2004; 82(3):573-8. DOI: 10.1016/j.fertnstert.2004.04.026. View

Shoham Z, Smith H, Yeko T, OBrien F, Hemsey G, ODea L . Recombinant LH (lutropin alfa) for the treatment of hypogonadotrophic women with profound LH deficiency: a randomized, double-blind, placebo-controlled, proof-of-efficacy study. Clin Endocrinol (Oxf). 2008; 69(3):471-8. DOI: 10.1111/j.1365-2265.2008.03299.x. View

Dahl K, Stone M . FSH isoforms, radioimmunoassays, bioassays, and their significance. J Androl. 1992; 13(1):11-22. View

. Efficacy and safety of highly purified menotropin versus recombinant follicle-stimulating hormone in in vitro fertilization/intracytoplasmic sperm injection cycles: a randomized, comparative trial. Fertil Steril. 2002; 78(3):520-8. DOI: 10.1016/s0015-0282(02)03250-8. View

Yarali H, Zeyneloglu H . Gonadotrophin treatment in patients with polycystic ovary syndrome. Reprod Biomed Online. 2004; 8(5):528-37. DOI: 10.1016/s1472-6483(10)61099-1. View

Brinsden P, Akagbosu F, Gibbons L, Lancaster S, Gourdon D, Engrand P . A comparison of the efficacy and tolerability of two recombinant human follicle-stimulating hormone preparations in patients undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2000; 73(1):114-6. DOI: 10.1016/s0015-0282(99)00450-1. View

Coccia M, Comparetto C, Bracco G, Scarselli G . GnRH antagonists. Eur J Obstet Gynecol Reprod Biol. 2004; 115 Suppl 1:S44-56. DOI: 10.1016/j.ejogrb.2004.01.033. View

le Cotonnec J, Porchet H, Beltrami V, Munafo A . Clinical pharmacology of recombinant human luteinizing hormone: Part I. Pharmacokinetics after intravenous administration to healthy female volunteers and comparison with urinary human luteinizing hormone. Fertil Steril. 1998; 69(2):189-94. DOI: 10.1016/s0015-0282(97)00501-3. View

10.

Broekmans F, Fauser B . Diagnostic criteria for polycystic ovarian syndrome. Endocrine. 2006; 30(1):3-11. DOI: 10.1385/ENDO:30:1:3. View

11.

Platteau P, Nyboe Andersen A, Balen A, Devroey P, Sorensen P, Helmgaard L . Similar ovulation rates, but different follicular development with highly purified menotrophin compared with recombinant FSH in WHO Group II anovulatory infertility: a randomized controlled study. Hum Reprod. 2006; 21(7):1798-804. DOI: 10.1093/humrep/del085. View

12.

Wide L, Bakos O . More basic forms of both human follicle-stimulating hormone and luteinizing hormone in serum at midcycle compared with the follicular or luteal phase. J Clin Endocrinol Metab. 1993; 76(4):885-9. DOI: 10.1210/jcem.76.4.8473400. View

13.

Fisch B, Avrech O, Pinkas H, Neri A, Rufas O, Ovadia J . Superovulation before IVF by recombinant versus urinary human FSH (combined with a long GnRH analog protocol): a comparative study. J Assist Reprod Genet. 1995; 12(1):26-31. DOI: 10.1007/BF02214125. View

14.

Kolibianakis E, Zikopoulos K, Albano C, Camus M, Tournaye H, Van Steirteghem A . Reproductive outcome of polycystic ovarian syndrome patients treated with GnRH antagonists and recombinant FSH for IVF/ICSI. Reprod Biomed Online. 2003; 7(3):313-8. DOI: 10.1016/s1472-6483(10)61870-6. View

15.

Wikland M, Hugues J, Howles C . Improving the consistency of ovarian stimulation: follitropin alfa filled-by-mass. Reprod Biomed Online. 2006; 12(6):663-8. DOI: 10.1016/s1472-6483(10)61078-4. View

16.

Barrenetxea G, Agirregoikoa J, Jimenez M, de Larruzea A, Ganzabal T, Carbonero K . Ovarian response and pregnancy outcome in poor-responder women: a randomized controlled trial on the effect of luteinizing hormone supplementation on in vitro fertilization cycles. Fertil Steril. 2007; 89(3):546-53. DOI: 10.1016/j.fertnstert.2007.03.088. View

17.

Emre Bakircioglu M, Erden H, Ciray H, Bayazit N, Bahceci M . Gonadotrophin therapy in combination with ICSI in men with hypogonadotrophic hypogonadism. Reprod Biomed Online. 2007; 15(2):156-60. DOI: 10.1016/s1472-6483(10)60703-1. View

18.

Gerli S, Bini V, Di Renzo G . Cost-effectiveness of recombinant follicle-stimulating hormone (FSH) versus human FSH in intrauterine insemination cycles: a statistical model-derived analysis. Gynecol Endocrinol. 2008; 24(1):18-23. DOI: 10.1080/09513590701690241. View

19.

Lunenfeld B . Development of gonadotrophins for clinical use. Reprod Biomed Online. 2002; 4 Suppl 1:11-7. DOI: 10.1016/s1472-6483(12)60006-6. View

20.

Zelinski-Wooten M, Hutchison J, Hess D, Wolf D, Stouffer R . Follicle stimulating hormone alone supports follicle growth and oocyte development in gonadotrophin-releasing hormone antagonist-treated monkeys. Hum Reprod. 1995; 10(7):1658-66. DOI: 10.1093/oxfordjournals.humrep.a136151. View