29 June, 2004
Ferring leads the way with an ESHRE symposia focused on the role of LH and hCG in the reproductive system and its implications for better infertility treatment
Infertility specialists from around the world confirmed that the activation of LH/hCG receptors in the uterus, fallopian tubes and early embryos may result in important pregnancy promoting actions during the complicated process of ART (Assisted Reproductive Techniques) and IVF.
Indeed, the receptor actions may be strong enough to work in the prevention of miscarriage and preterm delivery. (ref1) New data also suggests that hCG/LH activity may have a beneficial effect on the blood flow in the endometrium consequently improving the chances of successful egg implantation.
Most specialists see the importance of LH activity during the follicular phase in ovarian stimulation but the newest data focuses on the actions of non gonadal organs which are important in the pregnancy process and also contain more LH/hCG receptors.
'We are forcing a shift in the old paradigm that LH and hCG are strictly gonadal regulating hormones. These 'other' receptors distributed throughout the body encompass a total body approach when trying to improve IVF pregnancy rates,' said Prof. C.V Rao of the Department of Obstetrics, Gynecology and Women's Health at the University of Louisville, Kentucky.
For example, human fallopian tubes have the highest amount of LH/hCG receptors in the epithelial cells which promote gamete maturation, fertilization and early embryonic growth and development and transport of the embryo in the uterus.
Scientists concluded that influencing various organs that are partners in the reproductive system may strengthen early stage development of embryos and prevent miscarriages in assisted reproduction techniques.
The new data is particularly relevant for the infertility treatment MENOPUR which contains a combination of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) --activity similar to those involved in the natural reproductive cycle. In MENOPUR the LH activity primarily descends from the hormone hCG which also naturally occurs in the product.
Today's symposia findings also support data published in the May issue of Fertility and Sterility which suggested that women undergoing IVF treatment with MENOPUR had a significantly improved chance of becoming pregnant
The publication was based on a sub-analysis of the landmark trial EISG (European-Israeli Study Group) which was designed to demonstrate non-inferiority of MENOPUR (HP-hMG) when compared with GONAL F (rFSH, Serono Group) in more than 700 IVF and ICSI patients.
The sub-analysis showed the following results: the ongoing pregnancy rate in the 233 women who underwent IVF was significantly higher in the MENOPUR group (31%) compared with the GONAL F group (20%), (p=0.037) . - a difference of 50%.
The study analysis also showed that although less oocytes were retrieved in the MENOPUR group vs. GONAL F, MENOPUR appeared to have a clear beneficial effect on the pregnancy rates in women undergoing IVF.
According to the sub-analysis, adequate hCG levels during treatment with MENOPUR group appear to have a favourable impact on ongoing pregnancy rates in IVF and ICSI patients, but more markedly in IVF.
The sub-analysis authors suggest that the beneficial effect of the LH activity in MENOPUR seen in IVF patients could also be mediated by cumulus oophorus cells which are present during the IVF and not during the ICSI procedure.
To confirm the sub-analysis results, Ferring launched a state-of-the-art prospective, multi-national, comparative study powered to demonstrate superiority of MENOPUR vs GONAL F in IVF patients on ongoing pregnancy rate. The study called MERiT will be the largest, international prospective superiority trial comparing MENOPUR vs. GONAL F in IVF.
'We would like to define evidence based medicine in IVF by identifying the most efficient interventions that will results in pregnancy and reduce risks for our patients,' said Dr. Pascal Danglas, vice-president of Clinical and Product Development at Ferring.
The ESHRE session was sponsored, through an unrestricted educational grant, by Ferring Pharmaceuticals, a global leader in developing treatments for infertility. Ferring's product MENOPUR, licensed for use in Europe for the treatment of infertility contains both luteinizing hormone activity as well as follicle stimulating hormone.
Ferring is a research driven, speciality biopharmaceutical group active in global markets. The company identifies, develops and markets innovative products in the areas of endocrinology, gastroenterology, gynecology, infertility and urology.
In recent years Ferring has expanded beyond its traditional European base and now has operating subsidiaries in over 40 countries.
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