Can replacing follicle-stimulating hormone with an alternative hormone reduce the cost of in vitro fertilization?

This study compared the use of follicle-stimulating hormone (FSH) with human chorionic gonadotropin (hCG) during egg preparation for in vitro fertilization (IVF). The results showed that hCG reduced the cost of IVF considerably and was as effective as FSH for egg preparation.

One of the major considerations for couples undergoing IVF is cost. Many factors add to the cost, including the hormones used to stimulate and prepare eggs for harvesting. These hormones are administered to patients in three phases. The first phase uses follicle-stimulating hormone (FSH) to stimulate the ovaries to prepare eggs. The second phase uses a different dose of FSH to promote the maturation and growth of eggs. The third phase uses a high dose of human chorionic gonadotropin (hCG) to complete egg maturation.

FSH is an expensive drug but hCG is not as expensive. Other studies have shown that a low dose of hCG during the second phase of egg preparation can do the same job as FSH. It is unclear if this substitution is as effective for the harvesting of eggs for IVF.

105 patients undergoing IVF were divided into two groups. Group A (50 patients) received a low dose of hCG during the second phase of egg preparation. Group B (55 patients) received the standard dose of FSH during the second phase of egg preparation. All patients received the same dose of FSH during the first phase and of hCG during the third phase of egg preparation. Patients were examined 15 days after IVF was completed to see if they were pregnant.

There were a similar number of pregnancies in both groups. 30% of patients in Group A and 22.8% of patients in Group B became pregnant. hCG significantly reduced the cost of egg preparation for IVF treatment compared to FSH. The cost per pregnancy was reduced from €4902 in Group B to €2684 in Group A. 

The authors concluded that low-dose hCG is a cheaper and effective alternative to FSH for the second phase of egg preparation.

This study was limited by the small number of patients that participated.