#263 : Follitropin Delta for Controlled Ovarian Stimulation: Evaluating Dose Equivalence Approach

Abstract

Background and Aims: The use of Follitropin Delta (FD) according to ESTHER-1 study algorithm for controlled ovarian stimulation (COS) protocol yielded less sufficient ovarian response in our previous experience. On the other hand, phase II and III FD clinical dose-response trials have provided dose equivalence concept between FD and Follitropin Alpha (FA) in which 10 mcg of FD was equivalent to 150 IU of FA.[Formula: see text] This study, therefore, aimed to explore an alternative approach to dose individualization of FD according to dose equivalence with FA. Methods: This was a prospective observational study. Inclusion criteria were patients who underwent IVF with FD for COS. Starting dose of each patient was prescribed according to the investigator’s experience using conventional FA dose (IU) which was then converted to FD dose (mcg) based on dose equivalence data. Results: A total of 108 women were recruited in this study. 80% of the participants were good prognosis patients. The median daily dose and total dose of FD were 15 mcg and 162 mcg, respectively (Table 1). This study observed favorable laboratory outcomes including number of retrieved oocytes, mature oocytes, fertilization rate, number and top-quality embryos at either the cleavage or blastocyst stage. In addition, 75% of the subjects acquired a surplus of frozen embryos which could be transferred in the next cycle (Table 2). Remarkable clinical outcomes were noted as follows: biochemical pregnancy of 74.2%, clinical pregnancy of 67.7%, and lowincidence of ovarian hyperstimulation syndrome (OHSS) of 3.7% (Table 3). Conclusion: Dose equivalence approach of FD to FA during COS results in favorable IVF outcomes in relation to both the embryology laboratory and clinical outcomes. This result supports the establishment of dose equivalence concept between FD and FA for routine clinical practice of IVF.