Comparison of the efficacy and safety of hMG and r-FSH+LH preparations with different sources of luteinizing hormone biological activity: a single-center cohort study

Relevance: Assisted reproductive technologies (ART) play a key role in the treatment of infertility, and one of the important components of controlled ovarian stimulation (COS) protocols is adequate hormonal support, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Both human menopausal gonadotropin (HMG), which contains LH activity, and recombinant drugs, such as r-FSH+LH combinations, are used in clinical practice. However, differences in the sources of LH activity may affect both the pharmacodynamics and the clinical efficacy and safety of these drugs. The study aimed to compare the effectiveness of FSH- and LH-containing drugs in relation to the clinical outcome of controlled ovarian stimulation. Materials and Methods: A cohort single-center study was conducted from January 2023 to December 2024 at PERSONA International Clinical Center for Reproductive Medicine (Almaty, Kazakhstan). Ninety women with infertility were included in the study and divided into three groups. The clinical outcomes of the groups were compared: the primary endpoints were the total number of retrieved oocytes, the total number of fertilized oocytes, and the number of good-quality blastocysts with Gardner grade ≥3AB. Results: There was no statistically significant difference in stimulation duration, total dose of exogenous FSH, number of retrieved oocytes, number of normally fertilized oocytes, number of 3-day embryos, average number of blastocysts obtained, and average number of embryos of good morphological quality between the groups. Conclusions: When choosing a COS scheme, reproductive specialists consider various gonadotropin regimens – FSH-only and HMG-combined. The choice of a particular drug depends on its availability, clinical preferences, ease of use, and cost. Thus, the study confirms that the new HMG drug, which has LH activity due to the added placental human chorionic gonadotropin, is a promising alternative for ovarian stimulation in IVF protocols.