A comparison of live birth rates and cumulative ongoing pregnancy rates between Europe and North America after ovarian stimulation with corifollitropin alfa or recombinant follicle-stimulating hormone

Capsule:
Live birth rates and cumulative pregnancy rates were higher in North America than in Europe after treatment with either corifollitropin alfa or daily recombinant FSH in a double-blind prospective randomized controlled trial.

Authors:
Robert Boostanfar, M.D., Bernadette Mannaerts, M.Sc., Samuel Pang, M.D., Manuel Fernandez-Sanchez, M.D., Han Witjes, Ph.D., Paul Devroey, M.D., Ph.D., Engage Investigators
Volume 97, Issue 6 , Pages 1351-1358, June 2012

Objective:
To compare live birth rates after fresh embryo transfer (ET) and cumulative ongoing pregnancy rates after fresh ET and frozen-thawed (ET) between continents and overall after one treatment cycle with corifollitropin alfa or recombinant FSH.

Design:
Double-blind, multicenter, randomized controlled trial.

Setting:
Fourteen centers in North America (NA); 20 in Europe (EU).

Patient(s):
804 NA patients and 702 EU patients.

Intervention(s):
Patients >60 kg received a single dose of corifollitropin alfa or daily rFSH for the first 7 days of controlled ovarian stimulation.

Main Outcome Measure(s):
Live birth rates.

Result(s):
Within each continent no differences were noted between the two treatment groups; however, between continents, the cumulative ongoing pregnancy rate and live birth rate were considerably higher in NA than in EU. The live birth rate in NA was 39.2% in both treatment groups compared with 31.5% and 28.8% in EU after corifollitropin alfa and rFSH treatment, respectively. Considering the number of embryos transferred, the live birth rate per ET was still higher in NA than in EU (42.7% v.s 36.8% with corifollitropin alfa and 41.6% vs. 30.9% with rFSH). Overall live birth rates after fresh ET were 35.6% and 34.4% (estimated difference 1.1% [95% confidence interval −3.7–5.8]), and the estimated cumulative live birth rates were 43.4% and 41.3% with corifollitropin alfa and rFSH, respectively.

Conclusion(s):
Live birth rates and cumulative pregnancy rates were higher in NA than in EU after treatment with either corifollitropin alfa or daily rFSH; both treatment protocols provided equal success rates.

ClinicalTrials.gov Identifiers:
NCT00703014 and NCT00702273.

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