Summary The objective of this study was to compare embryonic morphokinetic parameters and clinical outcomes of two controlled ovarian stimulation (COS) protocols in women of advanced maternal age (AMA): Pergoveris (r-hFSH:r-hLH, 2:1 ratio) versus r-hFSH monotherapy (GONAL-f). This retrospective, non-interventional descriptive study was conducted at a private university–affiliated IVF center and included 136 ICSI cycles performed in AMA patients between March 2019 and May 2020. Patients were grouped by COS protocol (GONAL-f, n = 64; Pergoveris, n = 72), and embryo morphokinetics and ICSI outcomes were extracted from the clinic’s database; the main outcome was time to complete blastulation (tB, hours). Embryos from the Pergoveris group reached tB earlier than those from the GONAL-f group (mean 109.3 h vs 112.6 h), and all morphokinetic milestones occurred sooner with Pergoveris, alongside lower multinucleation rates at the 2-cell and 4-cell stages. Although blastocyst development was higher in the GONAL-f group, Pergoveris was associated with higher oocyte yield and maturity, higher implantation, clinical and ongoing pregnancy rates, and lower miscarriage and OHSS rates; Pergoveris cycles also required higher gonadotropin doses and longer stimulation. Overall, embryos from the r-hFSH:r-hLH group exhibited faster morphokinetic timings and improved implantation and pregnancy outcomes, and prospective studies are warranted to confirm these observations.
Borges et al. (Mon,) studied this question.