Efficacy, efficiency and effectiveness of gonadotropin therapy for infertility treatment

• Main Author: Sandro C. Esteves
• Format: Article
• Language: English
• Published: Mavera, Edições Científicas e Técnicas Ltda
• Series: Medical Express
• Subjects: gonadotrofinas; estimulação ovariana controlada; tecnologia reprodutiva assistida
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2358-04292015000300002&lng=en&tlng=en

Gonadotropin therapy is an essential element in infertility treatments involving assisted reproductive technology. In recent years there have been outstanding advances in the development of new gonadotropins, particularly with the production of gonadotropins using biotechnological resources. Recombinant gonadotropins have higher specific activity compared with urinary counterparts, thus allowing subcutaneous administration of minimal amounts of glycoprotein. As a result, recombinant formulations have a better safety profile despite an overall similarity in terms of efficacy for pregnancy, as reported in many randomized controlled trials and meta-analyses. Gonadotropins stimulate the ovaries to develop follicles and oocytes, which are the raw material for fertilization and embryo production. The resulting embryos are transferred (fresh or frozen-thawed) to achieve pregnancy. The efficiency of a gonadotropin should therefore measured by the amount of drug used, the number of oocytes/embryos produced, and the number of pregnancies achieved by transferring fresh and/or frozen-thawed embryos to the uterus (cumulative pregnancy). Comparisons between different gonadotropin preparations should also take into account other important quality indicators in reproductive medicine, such as safety and patient-centeredeness. Altogether, the aforementioned quality indicators favor biotech gonadotropins over biologic products in infertility therapy.