F&S Reports (Dec 2020)

Economic evaluation of highly purified human menotropin or recombinant follicle-stimulating hormone for controlled ovarian stimulation in high-responder patients: analysis of the Menopur in Gonadotropin-releasing Hormone Antagonist Single Embryo Transfer–High Responder (MEGASET-HR) trial

  • Jared C. Robins, M.D.,
  • Andrew F. Khair, Ph.D., M.B.A.,
  • Eric A. Widra, M.D.,
  • Michael M. Alper, M.D.,
  • Winnie W. Nelson, Pharm.D., M.S., M.B.A.,
  • Eric D. Foster, Ph.D.,
  • Anshul Sinha, B.Tech.,
  • Masakazu Ando, Ph.D.,
  • Patrick W. Heiser, Ph.D.,
  • Gaurang S. Daftary, M.D., M.B.A.

Journal volume & issue
Vol. 1, no. 3
pp. 257 – 263

Abstract

Read online

Objective: To determine the cost of achieving a live birth after first transfer using highly purified human menotropin (HP-hMG) or recombinant follicle-stimulating hormone (FSH) for controlled ovarian stimulation in predicted high-responder patients in the Menopur in Gonadotropin-releasing hormone Antagonist Single Embryo Transfer–High Responder (MEGASET-HR) trial. Design: Cost minimization analysis of trial results. Setting: Thirty-one fertility centers. Patient(s): Six hundred and nineteen women with serum antimüllerian hormone ≥5 ng/mL. Intervention(s): Controlled ovarian stimulation with HP-hMG or recombinant FSH in a gonadotropin-releasing hormone (GnRH) antagonist assisted reproduction cycle where fresh transfer of a single blastocyst was performed unless ovarian response was excessive whereupon all embryos were cryopreserved and patients could undergo subsequent frozen blastocyst transfer within 6 months of randomization. Main Outcome Measure(s): Mean cost of achieving live birth after first transfer (fresh or frozen). Result(s): First-transfer efficacy, defined as live birth after first fresh or frozen transfer, was 54.5% for HP-hMG and 48.0% for recombinant FSH (difference 6.5%). Average cost to achieve a live birth after first transfer (fresh or frozen) was lower with HP-hMG compared with recombinant FSH. For fresh transfers, the cost was lower with HP-hMG compared with recombinant FSH. The average cost to achieve a live birth after first frozen transfer was also lower in patients treated with HP-hMG compared with recombinant FSH. Conclusion(s): Treatment of predicted high-responders with HP-hMG was associated with lower cost to achieve a live birth after first transfer compared with recombinant FSH. Clinical Trial Registration Number: NCT02554279.

Keywords