Menotrophin 1,200unit powder and solvent for solution for injection vials

Gonadotropin-releasing hormone-analog type, fertilization method, and number of embryos available for cryopreservation should be incorporated into economic evaluations of highly purified human menopausal gonadotropin (HP-hMG) and recombinant human follicle-stimulating hormone (r-hFSH), as they may affect treatment costs. We searched for randomized trials and meta-analyses comparing HP-hMG and r-hFSH. Meta-analysis showed no significant difference in live births (odds ratio 0.82, 95% confidence interval [CI] 0.66-1.01), but a greater number of oocytes with r-hFSH (mean difference [MD] 1.96, 95% CI 1.02-2.90). Using a cost-minimization model for Sweden, accounting for embryo availability, survival following thawing, and patient dropout, we simulated patients individually for up to three cycles. R-hFSH was found to be cost-saving, at 2,767 kr (95% CI 1,580-4,057) per patient (€315 or $411); baseline savings were 6.43% of the total HP-hMG cost. In fresh cycles only, the savings for r-hFSH were 1,752 kr (95% CI 48-3,658) per patient (€200 or $260). In univariate sensitivity analyses, savings were obtained until the price of r-hFSH increased by 30% or the dosage of HP-hMG decreased by 38%-62% of baseline value. In probabilistic sensitivity analysis, r-hFSH was cost-saving in 100% of the simulated cohort per patient and in 85% per live birth; the respective percentages for fresh cycles only were 97.3% and 73.1%. In conclusion, a greater number of oocytes with r-hFSH allows for more frozen embryo transfers, thereby reducing overall treatment cost.

Abstract licence: CC BY-NC

A woman in her 20s developed IgA vasculitis with nephritis (IgAVN), which started four days after oocyte donation (for in-vitro fertilisation (IVF) and transfer to another recipient). Prior to oocyte retrieval, the patient received a course of controlled ovarian stimulation (COS) with menotrophin, ganirelix acetate and choriogonadotropin alfa. Four days after COS, she developed a painful purpuric rash alongside knee pain and swelling. Prednisolone was started for presumed IgA vasculitis. Soon after, she developed de novo mononeuritis multiplex and renal dysfunction characterised by haematoproteinuria and nephrotic syndrome. A kidney biopsy confirmed the diagnosis of IgAVN. Symptoms improved over time; however, there remained questions about the possible trigger. The induced sex hormone changes associated with COS may have had an immunomodulatory effect, leading to disease development.

Abstract licence: CC BY

Abstract Object: This study was to investigate the effect of different human Menotrophin (hMG) initiation doses on in vitro fertilization (IVF) outcomes in aged poor ovarian response(POR) patients undergoing ovulation induction with Clomiphene Citrate (CC) combined with hMG; Method: The clinical data of 142 POR patients more than 40 years old were collected and were divided into 3 groups according to the initiation dose of hMG (Group A=75IU, Group B=150IU, Group C=225IU). The baseline characteristics and IVF outcomes were compared; Results: We found that with the increase of hMG initiation dose, the average number of oocytes retrieved increased, pair-to-pair comparison showed that the the average number of oocytes retrieved in Group Awas significantly lower than that in the Group B and Group C(PPP>0.05). Conclusions: For aged POR patients receiving CC combined with hMG, increasing hMG cannot improve patients' IVF outcomes and Pregnancy outcomes. 150IU of hMG initiation dose may be the better choice for aged POR patients.

Abstract licence: CC BY