The Effect of Follitropin Alfa in Controlled Ovarian Stimulation Protocol  for In Vitro Fertilization Cycles

Novita  Prasetiawati; Ayu  Mulia Sundari; Agus  Supriyadi; Hadi  Sjarbaini; Sudirmanto  Tarigan; Gde  Suardana; Gangsar  Pariyanti; Deana  Rosaria Indah; Euis  Purwatyningsih; Anom  Bowolaksono

doi:10.18502/jri.v24i2.12499

Novita Prasetiawati Graduate School of Biology, Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Indonesia, Depok, Indonesia
Ayu Mulia Sundari Graduate School of Biology, Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Indonesia, Depok, Indonesia
Agus Supriyadi Melati Infertility Clinic, Harapan Kita Women and Children Hospital, Jakarta, Indonesia
Hadi Sjarbaini Melati Infertility Clinic, Harapan Kita Women and Children Hospital, Jakarta, Indonesia
Sudirmanto Tarigan Melati Infertility Clinic, Harapan Kita Women and Children Hospital, Jakarta, Indonesia
Gde Suardana Melati Infertility Clinic, Harapan Kita Women and Children Hospital, Jakarta, Indonesia
Gangsar Pariyanti Melati Infertility Clinic, Harapan Kita Women and Children Hospital, Jakarta, Indonesia
Deana Rosaria Indah Melati Infertility Clinic, Harapan Kita Women and Children Hospital, Jakarta, Indonesia
Euis Purwatyningsih Melati Infertility Clinic, Harapan Kita Women and Children Hospital, Jakarta, Indonesia
Anom Bowolaksono Graduate School of Biology, Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Indonesia, Depok, Indonesia

DOI: https://doi.org/10.18502/jri.v24i2.12499

Keywords: Agonist, Antagonist, Follitropin alfa, Gonadotropin-releasing hormone (GnRH), In vitro fertilization, OHSS.

Abstract

Background: Follitropin alfa (FA) is one of the most widely used exogenous gona-dotropins in both agonist and antagonist protocols for controlled ovarian stimulation (COS) and in vitro fertilization (IVF). However, reports of its effectiveness are limited, particularly in terms of its impact on overall IVF outcomes and ovarian hyperstimulation syndrome (OHSS). Therefore, in this study, FA competency was investigated by evaluating its effect on IVF outcomes and OHSS, administering agonist and antagonist COS protocols.

Methods: A retrospective study with 120 subjects was conducted. Outcomes com-prising the number of retrieved and fertilized oocytes, quality of embryos, and clinical pregnancies were assessed. Statistical correlation between FA dose, IVF outcomes, and the incidence of OHSS was also analyzed. All statistical analyses were performed at 95% confidence level.

Results: There was no significant difference in both protocols regarding retrieved oocytes (p=0.604), fertilized oocytes (p=0.761), embryo quality including good, average, poor embryo (p=0.875, p=0.565, p=0.785), and clinical pregnancy (p= 0.844). However, FA doses in the agonist protocol were shown notably higher (p= 0.001). Negative correlations were also observed between FA dose and the number of retrieved oocytes (r=-0.255, p<0.01), fertilized oocytes (r=-0.296, p<0.01), and good quality embryos (r=-0.231, p<0.05).

Conclusion: Our study suggested that FA yields similar outcomes in both COS pro-tocols, but agonist protocols require higher doses of FA and evaluation of its effect on OHSS is an important area of research for further investigation.