The use of oral desogestrel in ovarian stimulation cuts costs and reduces doses of medication in egg donors
A team of investigators from the Reproductive Medicine Unit of Dexeus Mujer, led by Dr Francisca Martínez, has conducted an observational crossover study in egg donors to find out whether the administration of oral desogestrel (DSG) in cycles of ovarian stimulation to suppress follicle-stimulating hormone gave the same results in terms of obtaining oocytes and pregnancy rates as the administration of antagonist injections (ANT).
The study was conducted on a sample of 35 egg donors who underwent two ovarian stimulation treatments with corifollitropin (CFT), one with oral desogestrel (CFT-DSG) and another with injections of antagonists (CFT-ANT) between February 2015 and May 2017 and with a period of less than 20 months between the two treatments.
The investigators compared the results obtained in a total of 54 recipients in fresh donor egg cycles (29 from CFT-ANT cycles and 25 by CFT-DSG).
The total number of oocytes obtained was 17.4 ± 7.53 (CFT-ANT) compared to 18.63 ± 8.99 (CFT-DSG). The average number of transferred embryos was 1.3 ± 0.7 in the CFT-ANT group versus 1.1 ± 0.6 in the group receiving CFT-DSG; the pregnancy rate was similar in both: 52.0% versus 58.6%, respectively.
However, compared to CFT-ANT cycles, donors in CFT-DSG cycles received fewer injections and a lower dose of medication, so the latter treatments were considered more satisfactory, simpler and with a lower financial cost. Additionally, no cycles were cancelled due to inadequate ovarian response, nor were there any cases of ovarian hyperstimulation syndrome.
The authors conclude that the administration of oral desogestrel in the treatment of ovarian stimulation with corifollitropin (CFT-DSG) reduces daily hormone injections and the dose of hormone medication given to egg donors, making it a more simple, satisfactory and economical option from the point of view of medication costs, and as effective as the administration of hormonal injections of antagonists.
Cheaper, simpler, better: oral desogestrel versus antagonist injections for LH suppression in corifollitropin-stimulated cycles in the same oocyte donor. A crossover study.
F. Martínez, D. Rodríguez, E. Clua, J. Rodríguez-Purata, I. Rodríguez, B. Coroleu.
Department of Obstetrics, Gynaecology and Reproduction. Hospital Universitari Dexeus, Barcelona.
ESHRE 2018 poster