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Establishing the follitropin delta dose that provides a comparable ovarian response to 150 IU/day follitropin alfa

Joan‐Carles Arce, Per Larsson, Juan A. García-Velasco

2020Reproductive BioMedicine Online40 citationsDOIOpen Access PDF

Abstract

RESEARCH QUESTION: The objective of this investigation was to determine the daily follitropin delta dose (µg) providing a similar ovarian response to 150 IU/day follitropin alfa. DESIGN: The study was a post-hoc analysis of ovarian response in 1591 IVF/intracytoplasmic sperm injection (ICSI) patients undergoing ovarian stimulation in a gonadotrophin-releasing hormone antagonist protocol in two recent randomized, assessor-blind, controlled trials in the development programme for follitropin delta: a phase II dose-response trial with a reference arm of a fixed daily dose of 150 IU follitropin alfa throughout stimulation, and a phase III efficacy trial with a comparator arm of 150 IU/day follitropin alfa as a starting dose. RESULTS: Daily follitropin delta doses of 10.0 µg (95% confidence interval [CI] 7.9-12.8) and 10.3 µg (95% CI 9.7-10.8) yielded the same number of oocytes as 150 IU/day follitropin alfa for all patients participating in the phase II and III trials, respectively. When analysing patients with either normal or high ovarian reserve (based on serum anti-Mullerian hormone ≥15 pmol/l) and no dose changes, the same number of oocytes was obtained with 150 IU/day follitropin alfa and daily doses of follitropin delta of 9.7 µg (95% CI 7.5-12.4) and 9.3 µg (95% CI 8.6-10.1) in the two trials. Daily follitropin delta doses in the range 9.5-10.4 µg were consistently estimated to correspond to 150 IU/day follitropin alfa for serum oestradiol concentration and number of follicles ≥12 mm at the end of stimulation across analysis populations in the phase III trial. CONCLUSIONS: A daily follitropin delta dose of 10 µg provides a similar ovarian response to 150 IU/day follitropin alfa in IVF/ICSI patients.

Topics & Concepts

MedicineIntracytoplasmic sperm injectionGonadotropinFollicle-stimulating hormoneOvarian reserveConfidence intervalHormone antagonistInternal medicineGynecologyAndrologyPregnancyIn vitro fertilisationHormoneInfertilityLuteinizing hormoneBiologyEndocrine systemGeneticsOvarian function and disordersHypothalamic control of reproductive hormonesReproductive Biology and Fertility