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Weekly Fertility Shots Work as Well as Daily, Says Study
by Leigh Ann Woodruff, June 20, 2012
When a woman undergoes in vitro fertilization (IVF), typically she gets a daily shot of follicle stimulating hormone (FSH) in order to stimulate the ovaries and help produce multiple eggs. Now a new study has found that long-lasting weekly injections of fertility hormones are as safe and effective as the daily injections.
The longer-lasting FSH is called corifollitropin alfa, (brand name ELONVA®) and it has been approved for use in Europe since 2010. Corrifollitopin alfa has the ability to initiate and sustain multiple follicular growth for an entire week, so a single subcutaneous injection may replace the first seven injections of any conventional daily recombinant follicle stimulating hormone (rFSH) preparation for controlled ovarian hyperstimulation.
"In a typical IVF cycle, patients take seven to 11 days of shots," says Spencer Richlin, M.D., a fertility doctor and Surgical Director of Reproductive Medicine Associates of Connecticut. "This new weekly injection will allow them to take one to three shots. Patients who don't like needles, find the shots uncomfortable, or have trouble being in a private place at the same time everyday will appreciate the convenience of a weekly shot."
The weekly injections are not available in the United States yet. "We are waiting for FDA approval," Dr. Richlin explains. "We ssume they will be here in the next 1 to 2 years."
Researchers compared weekly and daily hormone injections in a Cochrane systematic review, which is a systematic review of primary research in human health care and health policy and is internationally recognized as the highest standard in evidence-based health care. The scientists included data from four trials involving 2,335 people in their review and found no difference in pregnancies or serious side effects between the two regimens. The review showed that women given medium doses of the new long-lasting hormone on a weekly basis are equally likely to become pregnant and are no more likely to have a miscarriage or ectopic pregnancy than those receiving daily FSH injections.
"Based on the study, there is no question that when it is approved in the U.S., reproductive centers will use it," Dr. Richlin says.
In a statement, the study authors said that further research is needed to establish whether corifollitropin alfa is as effective in women who respond poorly to fertility hormones and those who hyper-respond and produce higher than expected numbers of eggs. In addition, there is limited information about patient satisfaction with the longer-acting FSH. According to Merck & Co., Inc., the makers of the drug, the most frequently reported side effects during treatment with ELONVA in clinical trials are Ovarian Hyperstimulation Syndrome (OHSS), pelvic pain and discomfort, headache, nausea, fatigue and breast complaints (including tenderness). These side effects are found with daily FSH injections, too.
"For some patients, daily shots are stressful," Dr. Richlin says. "Anything we can do to make the journey easier is very important to our patients."