Highly purified-hMG versus rFSH in ovarian hyperstimulation in women undergoing elective fertility preservation: a retrospective cohort study

To compare recombinant FSH (rFSH) with highly purified-human menopausal gonadotrophin (hp-hMG) on ovarian response in women undergoing elective fertility preservation (FP). This retrospective study included 456 women who underwent elective FP with gonadotropin-releasing hormone (GnRH) antagonist or progestin-primed ovarian stimulation (PPOS) protocols between 01/2017-12/2021. Only the first treatment cycle of each woman was included. 341 women were stimulated with rFSH and 115 with hp-hMG, and the ovarian stimulation outcomes were compared. A multivariate linear regression assessed the impact of age, basal FSH, antral follicle count (AFC) and protocol and gonadotropin types on the outcomes. Women in the rFSH group were significantly younger, and their AFC was significantly higher than those in the hp-hMG group (35.50±2.12 vs. 35.99±2.13years, p=0.034 and 13.76±6.08 vs. 11.84±6.06, p=0.002). There were no significant group differences in the amount (p=0.645) and duration (p=0.265) of FSH stimulation. The estradiol level was significantly lower for the rFSH group compared to the hp-hMG group (2547.18±1648.21pg/mL vs. 3468.02±2497.69pg/mL, p<0.001), while the progesterone level was significantly higher (1.33±0.75 ng/mL vs. 1.01±0.52ng/mL, p=0.001). The numbers of retrieved and MII oocytes were significantly higher for the rFSH group compared with the hp-hMG group (16.82±10.95 vs. 13.25±9.66, p=0.02, and 13.22±9.13 vs. 9.76±7.11, p=0.005), while the maturity rates were comparable (p=0.103). Patients in the rFSH group had higher numbers of both retrieved and MII oocytes when undergoing elective FP.