Kocaeli Med J. 2023; 12(3): 363-369 | DOI: 10.5505/ktd.2023.40221

Comparison of The Effects of rFSH, rFSH+rLH and HP-HMG Preparations on Assisted Reproductive Technology Outcomes in Overweight or Obese Women without Polycystic Ovary Syndrome

Merve Demir¹, Özge Senem Yücel Çiçek¹, Emre Sertel¹, Leylim Yalçýnkaya¹, Sare Doðan¹, Osman Onur Daloðlu², Emek Doger¹, Birol Vural^1
1Department of Obstetrics and Gynecology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
²Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey.

INTRODUCTION: The aim of this study is to compare the results of using rFSH, rFSH+rLH and HP-HMG in assisted reproductive technology (ART) applications in obese or overweight patients without polycystic ovary syndrome (PCOS).
METHODS: This retrospective cohort study was conducted with women without PCOS but with a body mass index greater than 25 who underwent ovarian stimulation with the GnRH antagonist protocol during ART. Appropriate cycles of these patients were divided into three groups as rFSH, rFSH+rLH and HP-HMG according to the type of gonadotropin used. ART outcomes were compared between these three groups.
RESULTS: Ongoing pregnancy rate and grade 1 embryo rate were statistically higher in the rFSH+rLH group (41.2% and 71.7%, respectively) than in the rFSH group (14.3% and 47.2%, respectively). There was no statistical difference between the group that received rFSH and the group that received HP-HMG, and between the group that received rFSH+rLH and the group that received HP-HMG in terms of ongoing pregnancy rate and grade 1 embryo ratio. In addition, the endometrial thickness on the day of HCG was statistically significantly higher in the rFSH+rLH group compared to the HP-HMG group.
DISCUSSION AND CONCLUSION: The rFSH+rLH combination has a superior effect over rFSH alone on embryo quality and ongoing pregnancy in obese or overweight patients without PCOS. In addition, it is seen that the endometrium of these patients on the hCG day is thicker when rFSH+rLH is used than when HP-HMG is used.

Keywords: obesity, human menopausal gonadotropin, recombinant LH, assisted reproductive technology

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Polikistik Over Sendromu Olmayan Fazla Kilolu veya Obez Kadýnlarda rFSH, rFSH+rLH ve HP-HMG Preparatlarýnýn Yardýmcý Üreme Teknolojisi Sonuçlarý Üzerindeki Etkilerinin Karþýlaþtýrýlmasý

Merve Demir¹, Özge Senem Yücel Çiçek¹, Emre Sertel¹, Leylim Yalçýnkaya¹, Sare Doðan¹, Osman Onur Daloðlu², Emek Doger¹, Birol Vural^1
1Kocaeli Üniversitesi Týp Fakültesi, Kadýn Hastalýklarý ve Doðum Ana Bilim Dalý, Ýstanbul
²Saðlýk Bilimleri Üniversitesi Bursa Yüksek Ýhtisas Eðitim ve Araþtýrma Hastanesi, Ýç Hastalýklarý Ana Bilim Dalý, Endokrinoloji ve Metabolizma Hastalýklarý, Bursa

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý polikistik over sendromu (PKOS) olmayan obez veya fazla kilolu hastalarda yardýmcý üreme teknolojisi (YÜT) uygulamalarýnda rFSH, rFSH+rLH ve HP-HMG kullanýmýnýn sonuçlarýný karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Bu retrospektif kohort çalýþmasý, YÜT sýrasýnda GnRH antagonist protokolü ile over stimülasyonu uygulanan PKOS'suz ancak vücut kitle indeksi 25'in üzerinde olan kadýnlarla yürütüldü. Bu hastalarýn uygun sikluslarý kullanýlan gonadotropin tipine göre rFSH, rFSH+rLH ve HP-HMG olmak üzere üç gruba ayrýldý. YÜT sonuçlarý bu üç grup arasýnda karþýlaþtýrýldý.
BULGULAR: Devam eden gebelik oraný ve 1. derece embriyo oraný rFSH+rLH grubunda (sýrasýyla %41.2 ve %71.7) rFSH grubuna göre (sýrasýyla %14.3 ve %47.2) istatistiksel olarak daha yüksekti. rFSH alan grup ile HP-HMG alan grup arasýnda ve rFSH+rLH alan grup ile HP-HMG alan grup arasýnda devam eden gebelik oraný ve grade 1 embriyo oraný açýsýndan istatistiksel fark yoktu. Ayrýca HCG günü endometrial kalýnlýk rFSH+rLH grubunda HP-HMG grubuna göre istatistiksel olarak anlamlý derecede yüksekti.
TARTIÞMA ve SONUÇ: PKOS'suz obez veya fazla kilolu hastalarda rFSH+rLH kombinasyonunun embriyo kalitesi ve devam eden gebelik üzerinde tek baþýna rFSH'ye göre üstün etkisi vardýr. Ayrýca hCG gününde bu hastalarýn endometriyumunun rFSH+rLH kullanýldýðýnda HP-HMG kullanýldýðý duruma göre daha kalýn olduðu görülmektedir.

Anahtar Kelimeler: obezite, insan menopozal gonadotropin, rekombinant LH, yardýmcý üreme teknolojisi

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