OBJECTIVE
To compare the efficacy and safety of follitropin delta and follitropin alpha in Rekovelle and Gonal-f when used in IVF programs in patients with polycystic ovary syndrome (PCOS).
MATERIAL AND METHODS
The study included 86 infertile women aged 24—42 years with A-phenotypes, C-phenotypes or D-phenotype of PCOS. Stimulation of ovulation using follitropin delta (Rekovelle) and follitropin alpha (Gonal-f) in IVF cycles was performed in 42 and 44 patients, respectively. We studied the effect of the drugs used on the parameters of follicle and embryogenesis, the frequency of pregnancy per embryo transfer (ET), the proportion of women with ET performed in fresh cycles and with frozen embryos, the structure of reasons for ET withdrawal and the frequency of ovarian hyperstimulation syndrome (OHSS).
RESULTS
Appointment for ovarian stimulation with follitropin delta instead of follitropin alpha made it possible to: 1) obtain a larger number of oocytes (16.8±4.2 vs. 4 vs 73.1±3.9, p=0.025) and good quality blastocysts (3.1±0.5 vs 2.8±0.8, p=0.042); 2) to reduce the proportion of patients with poor (0% versus 13.6%, p=0.003) and hyperergic (11.9% versus 18.2%, p=0.415) ovarian response; 3) reduce the frequency of PE cancellations due to morphological defects (18.2% vs. 54.5%, p=0.04); 4) increase the proportion of women with the possibility of cryopreservation of embryos (76.2% versus 68.2%, p=0.407). The indicators of the frequency of pregnancy per ET and the incidence of mild form of early OHSS with the use of follitropin delta and follitropin alpha did not differ significantly (41.9% vs. 40.9% and 9.5% vs. 13.6%, p>0.05).
CONCLUSIONS
The appointment of follitropin delta and follitropin alpha in IVF programs in patients with PCOS is accompanied by a comparable therapeutic efficacy in terms of the frequency of pregnancy per ET and a similar safety profile in terms of the incidence and clinical severity of early OHSS. At the same time, when using follitropin delta instead of follitropin alpha, there is an improvement in the indicators of folliculo- and embryogenesis, which allows more frequent embryo transfer in fresh cycles and an increase in the proportion of women with cryopreservation of “extra” embryos.
