Thursday, February 21, 2019

Which hormone injection works best in IVF ?



There's still a lot of confusion as to whether we should use urinary gonadotropins or recombinant gonadotropins in IVF for superovulation ( = helping patients grow lots of follicles).
Historically, we used urinary gonadotropins for many years. These are biological products , extracted from the urine of menopausal women , and they still work very well.
The problem is that there is a lot of batch to batch variation , because the quality of the extracted hormones is not always consistent, and this can create a lot of problems, because patients don't respond well to the superovulation. This is why it's so important for doctors to insist on seeing the bioassay report of every batch of urinary gonadotropins which they use for their patients.
This is why the newer advance is to use recombinant DNA technology to produce rec FSH in the lab in vitro. These are  much purer molecules, but the problem is they are more expensive , and this adds to the patient's financial burden .
This is why  it's important to use a judicious mix of the two.
Their efficacy as far as growing follicles is exactly the same, but some doctors worry because of the LH which urinary gonadotropins contain , because LH is considered to be a villain in IVF.  However, in clinical practice, it makes absolutely no difference to IVF outcomes at all.
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