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Ma J, Wang M, Zuo Q, Ma H, Wu S. Analysis of use of different rFSHs during IVF/ICSI-assisted conception in elderly population and effect of double trigger on clinical outcomes. J Matern Fetal Neonatal Med 2024; 37:2352790. [PMID: 38777799 DOI: 10.1080/14767058.2024.2352790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To compare the number of oocytes retrieved and clinical outcomes of ovulation induction in an older population treated with in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) (IVF/ICSI) using different rFSH options and the effectiveness of antagonist treatment to induce ovulation using gonadotropin-releasing hormone agonists (GnRH-a) in combination with an human chorionic gonadotropin (HCG) trigger. METHODS A total of 132 fresh cycles were selected for this study, which were treated with IVF/ICSI in our hospital from March 2022 to December 2022. Observations were made according to different subgroups and the effects of different triggering methods on the number of oocytes obtained, embryo quality, and clinical outcomes. RESULTS The initial gonadotropin (Gn) dose, the number of oocytes, and the number of MII oocytes were higher in group A than in group B (p < .05), and the clinical pregnancy rate was 29.41% in group A. Group B had a clinical pregnancy rate of 27.5%. The double-trigger group was superior to the HCG-trigger group in terms of the number of 2PN, the number of viable embryos, and the number of high-quality embryos (p < .05). The use of a double-trigger regimen (OR = 0.667, 95%CI (0.375, 1.706), p = .024) was a protective factor for the clinical pregnancy rate, whereas AFC (OR = 0.925, 95%CI (0.867, 0.986), p = .017) was an independent factor for the clinical pregnancy rate. CONCLUSIONS The use of a dual-trigger regimen of GnRH-a in combination with HCG using an appropriate antagonist improves pregnancy outcomes in fresh embryo transfer cycles in older patients.
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Affiliation(s)
- Jianxin Ma
- Department of Reproductive Medicine, Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Cangzhou City, China
| | - Mengna Wang
- Department of Reproductive Medicine, Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Cangzhou City, China
| | - Qianqian Zuo
- Department of Reproductive Medicine, Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Cangzhou City, China
| | - Hong Ma
- Department of Reproductive Medicine, Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Cangzhou City, China
| | - Shangqing Wu
- Department of Reproductive Medicine, Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Cangzhou City, China
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Alcalá-Sánchez X, Cuapio-Padilla P, Salazar-López C, Rodríguez R, Teteltitla M, Bahena I, Betancourt M, Casas E, Casillas F, López A, Bonilla E. Comparison of DNA damage in granulosa cells of women undergoing controlled ovarian stimulation in in vitro fertilization protocols with the recombinant human follicle-stimulating hormones Corneumon ®, Gonal-F ®, Pergoveris ® and Puregon ®: a randomized trial. Arch Gynecol Obstet 2024; 309:2107-2114. [PMID: 38441601 DOI: 10.1007/s00404-024-07392-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/17/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE To compare the DNA damage in granulosa cells (GCs) of women undergoing ovarian-stimulated cycles with four widely used recombinant human follicle-stimulating hormones (rhFSH) in in vitro fertilization (IVF) protocols (Corneumon®, Gonal-F®, Pergoveris® and Puregon®). METHODS A randomized trial was carried out at a Mexican hospital. GCs were isolated from 18 women with infertility undergoing assisted reproductive techniques (ART). Four controlled ovarian stimulation (COS) protocols including Corneumon®, Gonal-F®, Pergoveris® or Puregon® were used. GCs DNA damage was assessed by the Comet assay. Two parameters were measured: comet tail length (CTL), and Olive tail moment (OTM, the percentage of DNA in the tail multiplied by the distance between the center of the tail and head). RESULTS Use of the different hrFSH in COS caused variable and statistically significant levels of DNA damage in GCs of infertile women. CTL was similar in the Corneumon® and Pergoveris® groups (mean values of 48.73 and 55.18, respectively) and Corneumon® CTL was significantly lower compared to the Gonal-F® and Puregon® groups (mean values of 61.98 and 91.17, respectively). Mean OTM values were significantly lower in Corneumon® and Pergoveris® groups, compared to Gonal-F® and Puregon® groups (25.59, 27.35, 34.76, and 47.27, respectively). CONCLUSION Use of Corneumon® and Pergoveris® in COS caused statistically significantly lower levels of DNA damage in GCs of infertile women undergoing ART, which could potentially correlate with better reproductive outcomes.
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Affiliation(s)
- Ximena Alcalá-Sánchez
- Department of Health Sciences, Metropolitan Autonomous University-Iztapalapa Campus, 09340, Mexico City, Mexico
- Master's Degree Program in Animal Reproduction Biology, Metropolitan Autonomous University-Iztapalapa Campus, 09340, Mexico City, Mexico
| | - Pedro Cuapio-Padilla
- HISPAREP Assisted Reproduction Clinic, Hospital Español, 11520 CDMX, Mexico City, Mexico
| | - Carlos Salazar-López
- HISPAREP Assisted Reproduction Clinic, Hospital Español, 11520 CDMX, Mexico City, Mexico
| | - Ricardo Rodríguez
- HISPAREP Assisted Reproduction Clinic, Hospital Español, 11520 CDMX, Mexico City, Mexico
| | - Mario Teteltitla
- Department of Health Sciences, Metropolitan Autonomous University-Iztapalapa Campus, 09340, Mexico City, Mexico
| | - Iván Bahena
- Department of Health Sciences, Metropolitan Autonomous University-Iztapalapa Campus, 09340, Mexico City, Mexico
| | - Miguel Betancourt
- Department of Health Sciences, Metropolitan Autonomous University-Iztapalapa Campus, 09340, Mexico City, Mexico
| | - Eduardo Casas
- Department of Health Sciences, Metropolitan Autonomous University-Iztapalapa Campus, 09340, Mexico City, Mexico
| | - Fahiel Casillas
- Department of Biology of Reproduction, Metropolitan Autonomous University-Iztapalapa Campus, 09340, Mexico City, Mexico
| | - Alma López
- Department of Health Sciences, Metropolitan Autonomous University-Iztapalapa Campus, 09340, Mexico City, Mexico
| | - Edmundo Bonilla
- Department of Health Sciences, Metropolitan Autonomous University-Iztapalapa Campus, 09340, Mexico City, Mexico.
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Budani MC, Fensore S, DI Marzio M, Tiboni GM. An updated meta-analysis comparing the efficacy and safety of biosimilar medicinal products to the original follitropin alfa. Minerva Obstet Gynecol 2024; 76:70-79. [PMID: 36534054 DOI: 10.23736/s2724-606x.22.05175-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The aim of this study was to provide an updated meta-analysis assessing the therapeutic equivalence between follitropin alfa biosimilars and the reference medication in women undergoing assisted reproductive technologies (ART). EVIDENCE ACQUISITION The studies included in the analysis were pooled together in order to estimate the log odds ratio (OR) for binary outcomes and the mean difference (MD) for continuous outcomes along with the corresponding 95% confidence intervals (CI) by using a random effects model. The heterogeneity between the studies was evaluated with the Higgins and χ2 tests. EVIDENCE SYNTHESIS No differences were found concerning the number of oocytes retrieved at ovum pick-up, the primary endpoint recommended by the European Medicines Agency (EMA) (MD -0.04 CI [-0.78, 0.71], P=0.92). A significantly higher clinical pregnancy rate (OR 0.70 CI [0.53, 0.93], P=0.01) was observed in the reference product group in comparison to the biosimilar follitropin alfa, whereas no statistically significant differences were found for biochemical pregnancy rate, take home baby rate, total follitropin alfa dose, duration of stimulation, and ovarian hyperstimulation syndrome risk. CONCLUSIONS The non-inferiority of biosimilar formulations in comparison to the reference product, with respect to number of oocytes retrieved at ovum pick-up, was shown.
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Affiliation(s)
- Maria C Budani
- ART Unit, General Hospital of Ortona, Ortona, Chieti, Italy
| | - Stefania Fensore
- Department of Philosophical, Pedagogical and Economic-Quantitative Sciences, G. d'Annunzio University, Pescara, Italy
| | - Marco DI Marzio
- Department of Philosophical, Pedagogical and Economic-Quantitative Sciences, G. d'Annunzio University, Pescara, Italy
| | - Gian M Tiboni
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy -
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Choo CW, Ahn YS, Kim KH, Lee JH, Moon KY, Choi BC, Kang YJ, Kim HY, Sim CH, Han JE, Kim CH, Jang EJ, Lee Y, Moon JW, Park DS, Won HJ, Kim AN, Kim JY, Kim KR, Ahn JH, Lee JY, Gwak H, Kim JH. Effectiveness and Safety of Recombinant Human Follicle-Stimulating Hormone (Follitrope™) in Inducing Controlled Ovarian Stimulation in Infertile Women in Real-World Practice: a Prospective Cohort Study. Reprod Sci 2023; 30:2842-2852. [PMID: 37067727 PMCID: PMC10480279 DOI: 10.1007/s43032-023-01228-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/27/2023] [Indexed: 04/18/2023]
Abstract
To evaluate the safety and effectiveness of recombinant human follicle-stimulating hormone (rhFSH [Follitrope™]) in infertile women undergoing in vitro fertilization (IVF). To identify predictors of ovarian response that induce optimal clinical outcomes. This multicenter prospective study enrolled infertile women who were scheduled to undergo IVF after ovarian stimulation with rhFSH (Follitrope™) following the gonadotropin-releasing hormone (GnRH) agonist or GnRH antagonist protocol. Predictive factors for ovarian response were identified in the GnRH antagonist group based on the number of oocytes retrieved. A total of 516 infertile women were enrolled, among whom 136 (except one who withdrew before administration) received rhFSH using the GnRH agonist protocol and 379 using the antagonist protocol. The mean number of oocytes retrieved was 13.4 in the GnRH agonist group and 13.6 in the GnRH antagonist group. The clinical pregnancy rates were 32.3% (30/93) and 39.9% (115/288) in the GnRH agonist and antagonist groups, respectively. The incidence of ovarian hyperstimulation syndrome was 1.8% and 3.4% in the GnRH agonist and antagonist groups, respectively. No other significant safety risks associated with rhFSH administration were identified. Body mass index, basal serum FSH and anti-Müllerian hormone levels, and antral follicle count were identified as predictors of ovarian response by multiple regression with backward elimination, and the final regression model accounted for 26.5% of the response variability. In real-world practice, rhFSH (Follitrope™) is safe and effective in inducing ovarian stimulation in infertile women. Patient characteristics identified as predictors can be considered to be highly related to optimal clinical outcomes.
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Affiliation(s)
- Chang-Woo Choo
- Department of Gynecologic Endocrinology, Female Infertility, Fertility Preservation, Seoul Maria Fertility Hospital, Seoul, Republic of Korea
| | | | - Kyu Hyun Kim
- Bucheon Maria Fertility Hospital, Bucheon, Republic of Korea
| | - Jae Ho Lee
- Ilsan Maria Fertility Hospital, Goyang, Republic of Korea
| | | | - Bum-Chae Choi
- Center for Infertility & Recurrent Miscarriage, Creation & Love Women's Hospital, Gwangju, Republic of Korea
| | - Young Je Kang
- Pyeongchon Maria Fertility Hospital, Anyang, Republic of Korea
| | - Hye Young Kim
- Department of Obstetrics and Gynecology, Fertility Center, Agaon Fertility Clinic, Seoul, Republic of Korea
| | - Chae Hee Sim
- Mamapapa and Baby Ob/Gy Clinic, Ulsan, Republic of Korea
| | - Ji Eun Han
- Miraeyeon Fertility Clinic, Seoul, Republic of Korea
| | | | - Eun Jeong Jang
- Pyeongchon Maria Fertility Hospital, Anyang, Republic of Korea
| | - Yoojin Lee
- MizMedi Hospital, Seoul, Republic of Korea
| | | | - Dong Soo Park
- CHA Daegu Medical Center, CHA University School of Medicine, Daegu, Republic of Korea
| | | | - An Na Kim
- Pyeongchon Maria Fertility Hospital, Anyang, Republic of Korea
| | - Ju-Young Kim
- Sae Ran Women's Clinic, Jeonju, Republic of Korea
| | | | - Ji Hyun Ahn
- Department of Obstetrics and Gynecology, Fertility Center, Agaon Fertility Clinic, Seoul, Republic of Korea
| | | | - Heemin Gwak
- Life Sciences, LG Chem, Ltd., Seoul, Republic of Korea
| | - Ji Hyang Kim
- Department of Obstetrics and Gynecology, Fertility Center of CHA Bundang Medical Center, CHA University School of Medicine, 64 Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, 13520, Republic of Korea.
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Venetis CA, Helwig C, Mol BW, Chua SJ, Longobardi S, Orvieto R, Lispi M, Storr A, D'Hooghe T. Correction: Biosimilar recombinant follitropin alfa preparations versus the reference product (Gonal-F®) in couples undergoing assisted reproductive technology treatment: a systematic review and meta-analysis. Reprod Biol Endocrinol 2023; 21:68. [PMID: 37496043 PMCID: PMC10369731 DOI: 10.1186/s12958-023-01114-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Affiliation(s)
- Christos A Venetis
- Unit for Human Reproduction, 1st Dept of OB/Gyn, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Centre for Big Data Research in Health, University of New South Wales, Kensington Campus, New South Wales, Australia
- IVF Australia, Sydney, NSW, 2000, Australia
| | | | - Ben W Mol
- Department of Obstetrics and Gynecology, University of Monash, Monash, Clayton, Victoria, 3168, Australia.
| | - Su Jen Chua
- Alfred Health, Melbourne, VIC, 3004, Australia
| | - Salvatore Longobardi
- Global Clinical Development, Merck Serono S.p.A (an affiliate of Merck KGaA, Darmstadt 64293, Germany), Rome, 00176, Italy
| | - Raoul Orvieto
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, 52621, Israel
- The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, 6997801, Israel
| | - Monica Lispi
- University of Modena and Reggio Emilia, Modena, MO, 41121, Italy
- GlobalMedical Affairs Fertility, Research and Development, Merck KGaA, F135/002, Darmstadt, 64293, Germany
| | - Ashleigh Storr
- Flinders Fertility, Adelaide, South Australia, 5045, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, 5042, Australia
| | - Thomas D'Hooghe
- GlobalMedical Affairs Fertility, Research and Development, Merck KGaA, F135/002, Darmstadt, 64293, Germany
- Research Group Reproductive Medicine, Department of Development and Regeneration, Organ Systems, Group Biomedical Sciences, KU Leuven (University of Leuven), Leuven, 3000, Belgium
- Department of Obstetrics and Gynecology, Yale University, New Haven, CT, 06510, USA
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Schwarze JE, Venetis C, Iniesta S, Falla E, Lukyanov V, de Agustin Calvo E, D Hooghe T, Roeder C, Matorras R. Originator recombinant human follitropin alfa versus recombinant human follitropin alfa biosimilars in Spain: A cost-effectiveness analysis of assisted reproductive technology related to fresh embryo transfers. Best Pract Res Clin Obstet Gynaecol 2022; 85:203-216. [PMID: 35227619 DOI: 10.1016/j.bpobgyn.2022.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 12/14/2022]
Abstract
This study compared the cost per live birth and cost-effectiveness of the originator recombinant human follicle-stimulating hormone follitropin alfa (r-hFSH-alfa) and r-hFSH-alfa biosimilars for ovarian stimulation prior to assisted reproductive technology treatment in Spain. A decision tree model was developed, comprising pregnancy and live birth for one treatment cycle with fresh embryo transfer. Clinical inputs were based on a recent meta-analysis by Chua et al. [4]. Cost inputs were extracted from publicly available Spanish sources. The costs per live birth were lower with originator r-hFSH-alfa (€18,138) versus r-hFSH-alfa biosimilars (€20,377). The incremental cost-effectiveness ratio was €7208 for originator r-hFSH-alfa versus biosimilars. Drug acquisition costs for originator r-hFSH-alfa represented 10.5% of total costs in the base case analysis, and 6.2% in a treatment cycle resulting in live birth with one fresh embryo transfer. Results from the sensitivity analyses confirmed the robustness of the findings.
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Affiliation(s)
| | - Christos Venetis
- Centre for Big Data Research in Health & School of Women's and Children's Health, UNSW Medicine & Health, Sydney, NSW, 2052, Australia; IVF Australia, Level 3, 15 Bowden Street, Alexandria, NSW, 2015, Australia.
| | - Silvia Iniesta
- Department of Obstetrics, Gynecology and Reproductive Medicine, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain; Department of Reproductive Medicine, Ruber Internacional Hospital, C/ La Maso, 38, Mirasierra, Madrid, 28034, Spain.
| | | | - Vasily Lukyanov
- IQVIA Real World Solutions, Herikerbergweg 314, 1101, CT, Amsterdam, Netherlands.
| | | | - Thomas D Hooghe
- Merck Healthcare KGaA, Frankfurter Str. 250, 64293, Darmstadt, Germany; Department of Development and Regeneration, Laboratory of Endometrium, Endometriosis & Reproductive Medicine, KU Leuven, Herestraat 49 - Box 805
- B-3000, Leuven, Belgium; Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University Medical School, New Haven, CT, 06510, USA.
| | - Claudia Roeder
- Pharma Value Consulting, Pilatusweg 6 Oberwil-Lieli, 8966, Switzerland.
| | - Roberto Matorras
- Department of Obstetrics and Gynecology, Human Reproduction Unit, Cruces University Hospital, Basque Country University, Plaza de Cruces, S/N 48903 Barakaldo, Bizkaia, Bilbao, Spain; Instituto Valenciano de Infertilidad, IVI Bilbao, IVIRMA, Landabarri Bidea, nº 3 - 2nd Floor, 48940, Leioa, Vizcaya, Bilbao, Spain.
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7
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Zhang H, Fan Y, Gao L, Wang B, Xu T, Wu M, Liu J, Zhu X, Li X, Chen H, Li C, Wang M, Liu C, Mao Y, Yang M, Ding Y. The effect of a single escalating dose of long-acting recombinant human follicle-stimulating hormone Fc fusion protein (KN015) on healthy, pituitary-suppressed women: first-in-human and randomized study on its pharmacokinetics, pharmacodynamics, and tolerability. Expert Opin Investig Drugs 2022; 31:1255-1263. [PMID: 36537742 DOI: 10.1080/13543784.2022.2151434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE KN015 is a long-acting, recombinant human follicle-stimulating hormone Fc fusion protein that induces follicle development. This first-in-human study evaluated the effect of KN015 on healthy, pituitary-suppressed women and examined its pharmacokinetics, pharmacodynamics, and tolerability. METHODS This phase I study was a double-blind, randomized, and placebo-controlled design with a single ascending dose (20, 40, and 60 μg, respectively). RESULTS After subcutaneous administration of a single dose, the maximum serum KN015 concentrations reached 1.57, 2.78, and 3.62 ng/mL, respectively, after baseline adjustment. Over this dose range, the median Tmax occurred at 240-312 h, and the half-life (t½) was 752-1160 h. Dose proportionality was shown across the studied dose range. In most subjects, follicular growth was observed, and the number and diameter of the follicles increased with an increasing dose. In the 40-μg and 60-μg groups, the mean numbers of follicles with a diameter of ≥17 mm were 3 and 4, respectively. There was no significant difference in adverse events between the KN015 and placebo groups. KN015 antibody was not detected in any of the dosage groups. CONCLUSION The administration of a single ascending dose of KN015 was tolerated and able to induce follicular growth. TRIAL REGISTRATION This trial is registered at the Chinese Clinical Trials website (http://www.chinadrugtrials.org.cn/index.html # CTR20160741) and ClinicalTrials.gov (https://clinicaltrials.gov/ # NCT03192527).
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Affiliation(s)
- Hong Zhang
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Yanyan Fan
- Department of Gynecology, The First Hospital of Jilin University, Jilin, China
| | - Lei Gao
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Boguang Wang
- Corning Jeri (Jilin) Biotechnology Co., Ltd, Jilin, China
| | - Ting Xu
- Corning Jeri (Jilin) Biotechnology Co., Ltd, Jilin, China
| | - Min Wu
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Jingrui Liu
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Xiaoxue Zhu
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Xiaojiao Li
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Hong Chen
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Cuiyun Li
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Meng Wang
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Chengjiao Liu
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
| | - Yanhong Mao
- Corning Jeri (Jilin) Biotechnology Co., Ltd, Jilin, China
| | - Mingtang Yang
- Corning Jeri (Jilin) Biotechnology Co., Ltd, Jilin, China
| | - Yanhua Ding
- Phase I Clinical Research Center, The First Hospital of Jilin University, Jilin, China
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Effect of pre-IVF incubation in maturation medium on oocyte maturity, fertilization, embryonic development, and clinical outcomes following embryo transfer. REPRODUCTIVE AND DEVELOPMENTAL MEDICINE 2022. [DOI: 10.1097/rd9.0000000000000029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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9
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Manzi L, Sepe N, Migliaccio W, Lanzoni L, Iozzino L, D’Angelo F, Colarusso L, Montenegro S, Palmese A, D’Hooghe T, Ulloa-Aguirre A, Koloda Y, Lispi M. Comparative Assessment of the Structural Features of Originator Recombinant Human Follitropin Alfa Versus Recombinant Human Follitropin Alfa Biosimilar Preparations Approved in Non-European Regions. Int J Mol Sci 2022; 23:ijms23126762. [PMID: 35743204 PMCID: PMC9223809 DOI: 10.3390/ijms23126762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/01/2022] [Accepted: 06/10/2022] [Indexed: 12/10/2022] Open
Abstract
Although the full primary structures of the alfa and beta subunits of reference r-hFSH-alfa and its biosimilars are identical, cell context-dependent differences in the expressing cell lines and manufacturing process can lead to variations in glycosylation profiles. In the present study, we compared the structural features of reference r-hFSH-alfa with those of five biosimilar preparations approved in different global regions outside Europe (Primapur®, Jin Sai Heng®, Follitrope®, Folisurge®, and Corneumon®) with respect to glycosylation, macro- and microheterogeneity, and other post-translational modifications and higher order structure. The mean proportion of N-glycosylation-site occupancy was highest in reference r-hFSH-alfa, decreasing sequentially in Primapur, Jin Sai Heng, Corneumon, Follisurge and Follitrope, respectively. The level of antennarity showed slightly higher complexity in Corneumon, Primapur and Follitrope versus reference r-hFSH-alfa, whereas Jin Sai Heng and Folisurge were aligned with reference r-hFSH-alfa across all N-glycosylation sites. Sialylation level was higher in Corneumon and Follitrope, but small differences were detected in other biosimilar preparations compared with reference r-hFSH-alfa. Jin Sai Heng showed higher levels of N-glyconeuramic acid than the other preparations. Minor differences in oxidation levels were seen among the different products. Therefore, in summary, we identified var ious differences in N-glycosylation occupancy, antennarity, sialylation and oxidation between reference r-hFSH-alfa and the biosimilar preparations analyzed.
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Affiliation(s)
- Lucio Manzi
- Characterization & Innovative Analytics Unit—Analytical Development Biotech—Global Analytical Development—Global Development & Launch—Global Healthcare Operation, Merck Serono S.p.A., 00176 Rome, Italy, an affiliate of Merck KGaA; (L.M.); (N.S.); (W.M.); (L.L.); (L.I.); (F.D.); (L.C.)
| | - Nunzio Sepe
- Characterization & Innovative Analytics Unit—Analytical Development Biotech—Global Analytical Development—Global Development & Launch—Global Healthcare Operation, Merck Serono S.p.A., 00176 Rome, Italy, an affiliate of Merck KGaA; (L.M.); (N.S.); (W.M.); (L.L.); (L.I.); (F.D.); (L.C.)
| | - Walter Migliaccio
- Characterization & Innovative Analytics Unit—Analytical Development Biotech—Global Analytical Development—Global Development & Launch—Global Healthcare Operation, Merck Serono S.p.A., 00176 Rome, Italy, an affiliate of Merck KGaA; (L.M.); (N.S.); (W.M.); (L.L.); (L.I.); (F.D.); (L.C.)
| | - Ludovica Lanzoni
- Characterization & Innovative Analytics Unit—Analytical Development Biotech—Global Analytical Development—Global Development & Launch—Global Healthcare Operation, Merck Serono S.p.A., 00176 Rome, Italy, an affiliate of Merck KGaA; (L.M.); (N.S.); (W.M.); (L.L.); (L.I.); (F.D.); (L.C.)
| | - Luisa Iozzino
- Characterization & Innovative Analytics Unit—Analytical Development Biotech—Global Analytical Development—Global Development & Launch—Global Healthcare Operation, Merck Serono S.p.A., 00176 Rome, Italy, an affiliate of Merck KGaA; (L.M.); (N.S.); (W.M.); (L.L.); (L.I.); (F.D.); (L.C.)
| | - Fabrizia D’Angelo
- Characterization & Innovative Analytics Unit—Analytical Development Biotech—Global Analytical Development—Global Development & Launch—Global Healthcare Operation, Merck Serono S.p.A., 00176 Rome, Italy, an affiliate of Merck KGaA; (L.M.); (N.S.); (W.M.); (L.L.); (L.I.); (F.D.); (L.C.)
| | - Lucia Colarusso
- Characterization & Innovative Analytics Unit—Analytical Development Biotech—Global Analytical Development—Global Development & Launch—Global Healthcare Operation, Merck Serono S.p.A., 00176 Rome, Italy, an affiliate of Merck KGaA; (L.M.); (N.S.); (W.M.); (L.L.); (L.I.); (F.D.); (L.C.)
| | | | - Angelo Palmese
- Characterization & Innovative Analytics Unit—Analytical Development Biotech—Global Analytical Development—Global Development & Launch—Global Healthcare Operation, Merck Serono S.p.A., 00176 Rome, Italy, an affiliate of Merck KGaA; (L.M.); (N.S.); (W.M.); (L.L.); (L.I.); (F.D.); (L.C.)
- Correspondence: (A.P.); (T.D.)
| | - Thomas D’Hooghe
- Merck Healthcare KGaA, 64293 Darmstadt, Germany; (S.M.); (M.L.)
- Department of Development and Regeneration, Laboratory of Endometrium, Endometriosis & Reproductive Medicine, KU Leuven, Herestraat 49-Box 805, B-3000 Leuven, Belgium
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University Medical School, New Haven, CT 06510, USA
- Correspondence: (A.P.); (T.D.)
| | - Alfredo Ulloa-Aguirre
- Research Support Network (RAI), Universidad Nacional Autónoma de México-Instituto Nacional de Ciencias Médicas y Nutrición SZ, Tlalpan, Mexico City 14000, Mexico;
| | - Yulia Koloda
- Department of Obstetrics and Gynecology, Russian Medical Academy of Continuous Professional Education, Centre of Reproduction “Life Line”, 121471 Moscow, Russia;
| | - Monica Lispi
- Merck Healthcare KGaA, 64293 Darmstadt, Germany; (S.M.); (M.L.)
- PhD School of Clinical and Experimental Medicine, Unit of Endocrinology, University of Modena and Reggio Emilia, 41121 Modena, Italy
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10
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Guo Z, Kang B, Wu D, Xiao H, Hao L, Hao B, Liao S. Case Report: Twin Pregnancy Gives Birth to a Girl with Partial Trisomy 21 Mosaicism after in vitro Fertilization and Embryo Transfer. Front Genet 2022; 12:740415. [PMID: 35185999 PMCID: PMC8850307 DOI: 10.3389/fgene.2021.740415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: To report a rare case in which an IVF-ET twin pregnancy gave birth to a partial trisomy 21 chimera girl. Design: Case report. Setting: University hospital. Patient: A girl with partial trisomy 21 mosaicism after in vitro fertilization and embryo transfer. Interventions:In vitro fertilization (IVF) and embryo transfer (ET). Main Outcome Measure: Karyotype analysis, Copy Number Variation sequencing (CNV-seq), stLFR-WGS, and Short Tandem Repeat (STR) analysis. Results: Being assisted with IVF and EF technology, the couple successfully gave birth to twin sisters at 37 weeks of gestational age. The NonInvasive Prenatal Testing (NIPT) and Nuchal Translucency (NT) examination showed no detectable genetic abnormalities during pregnancy. However, the younger infant displayed growth retardation and feeding difficulties after birth, which was not observed in her twin sister. Further genetic counseling and diagnosis suggested that she is a Chimera with complex partial trisomy 21. The stLFR-WGS assay showed multiple CNV variations in Chr21 and STR analysis confirmed the paternal origin of the additional fragments. Conclusion: It is rare for IVF-ET-assisted twin pregnancy to give birth to a girl with a complex combination of abnormal Chr21, which might result from paternal chromosome rearrangement during meiosis and mitosis.
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Affiliation(s)
- Zhenglong Guo
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetic Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- School of Medicine, People’s Hospital of Henan University, Henan University, Zhengzhou, China
| | - Bing Kang
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetic Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- School of Medicine, People’s Hospital of Henan University, Henan University, Zhengzhou, China
| | - Dong Wu
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetic Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- School of Medicine, People’s Hospital of Henan University, Henan University, Zhengzhou, China
| | - Hai Xiao
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetic Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- School of Medicine, People’s Hospital of Henan University, Henan University, Zhengzhou, China
| | - Leilei Hao
- Department of Biology, University of Pennsylvania, Philadelphia, PA, United States
| | - Bingtao Hao
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetic Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- School of Medicine, People’s Hospital of Henan University, Henan University, Zhengzhou, China
- School of Basic Medical Sciences, Cancer Research Institute, Southern Medical University, Guangzhou, China
- *Correspondence: Bingtao Hao, ; Shixiu Liao,
| | - Shixiu Liao
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetic Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- School of Medicine, People’s Hospital of Henan University, Henan University, Zhengzhou, China
- *Correspondence: Bingtao Hao, ; Shixiu Liao,
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11
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Chua SJ, Mol BW, Longobardi S, Orvieto R, Venetis CA, Lispi M, Storr A, D'Hooghe T. Biosimilar recombinant follitropin alfa preparations versus the reference product (Gonal-F®) in couples undergoing assisted reproductive technology treatment: a systematic review and meta-analysis. Reprod Biol Endocrinol 2021; 19:51. [PMID: 33794909 PMCID: PMC8017804 DOI: 10.1186/s12958-021-00727-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/04/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Live birth has increasingly been identified as the standard clinical approach to measure the success of medically assisted reproduction (MAR). However, previous analyses comparing biosimilar preparations of follitropin alfa versus the reference product (GONAL-f®, Merck KGaA, Darmstadt, Germany or GONAL-f® RFF; EMD Serono, Inc., Rockland, MA), have had insufficient power to detect differences in clinically meaningful outcomes such as live birth. METHODS Medline, Embase, the Cochrane Library, Web of Science and clinical trial registries were searched for randomised controlled trials (RCTs) and conference abstracts comparing biosimilar follitropin alfa versus the reference product in controlled ovarian stimulation (COS) cycles published before 31 October 2020. Only studies in humans and publications in English were included. Retrieved studies were screened independently by two authors based on titles and abstracts, and then by full text. INCLUSION CRITERIA RCTs comparing follitropin alfa biosimilar preparations with the reference product in infertile patients of any age, with any type of infertility for any duration, undergoing COS for the purposes of MAR treatment (including frozen cycles). The primary outcome was live birth. Combined data for biosimilar preparations were analysed using a fixed-effects model. RESULTS From 292 unique records identified, 17 studies were included in the systematic review, representing five unique RCTs that were included in the meta-analysis. Rates of live birth (RR = 0.83, 95% CI 0.71, 0.97; 4 RCTs, n = 1881, I2 = 0%), clinical pregnancy (RR = 0.82, 95% CI 0.72, 0.94; 4 RCTs, n = 2222, I2 = 0%) and ongoing pregnancy (RR = 0.81, 95% CI 0.68, 0.96; 4 RCTs, n = 1232, I2 = 0%) were significantly lower with biosimilar preparations versus the reference product. Rates of cumulative live birth and cumulative clinical pregnancy were also significantly lower with biosimilars versus the reference product. There was high risk of publication bias. CONCLUSIONS This meta-analysis included data from RCTs evaluating the efficacy and safety of the biosimilar follitropin alfa preparations and demonstrated lower probability of live birth and pregnancy (ongoing and clinical) in couples treated with biosimilar preparations compared with the reference product. This study provides more insight into the differences between biosimilar r-hFSH preparations and the reference product than previously reported. TRIAL REGISTRATION Registration number: CRD42019121992 .
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Affiliation(s)
- Su Jen Chua
- Austin Health, Heidelberg, VIC, 3084, Australia.
| | - Ben W Mol
- Department of Obstetrics and Gynecology, University of Monash, Monash, Clayton, Victoria, 3168, Australia
| | - Salvatore Longobardi
- Global Clinical Development, Merck Serono S.p.A (an affiliate of Merck KGaA, Darmstadt 64293, Germany), 00176, Rome, Italy
| | - Raoul Orvieto
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, 52621, Israel
- The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, 6997801, Israel
| | - Christos A Venetis
- School of Women's and Children's Health & Centre for Big Data Research in Health, University of New South Wales, Clayton, Victoria, 2052, Australia
- IVF Australia, Sydney, NSW, 2000, Australia
| | - Monica Lispi
- University of Modena and Reggio Emilia, Modena, MO, 41121, Italy
- Global Medical Affairs Fertility, Research and Development, Merck KGaA, F135/002, Darmstadt, 64293, Germany
| | - Ashleigh Storr
- Flinders Fertility, Adelaide, South Australia, 5045, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, 5042, Australia
| | - Thomas D'Hooghe
- Global Medical Affairs Fertility, Research and Development, Merck KGaA, F135/002, Darmstadt, 64293, Germany
- Research Group Reproductive Medicine, Department of Development and Regeneration, Organ Systems, Group Biomedical Sciences, KU Leuven (University of Leuven), Leuven, 3000, Belgium
- Department of Obstetrics and Gynecology, Yale University, New Haven, CT, 06510, USA
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