JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):50
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263589

P-38. Comparative Analysis of Ovarian Stimulation with Alpha-Follitropin Versus Delta-Follitropin in Oocyte Retrieval: A Retrospective Study

Andressa C Silva¹, Lorena Cristina Santos¹, Mario Silva Approbato¹, Eduardo Camelo Castro¹, Polyana Almeida Barbosa¹, Alexandre Vieira Santos Moraes¹

¹Universidade Federal de Goias - Goiânia - GO - Brasil

Objective: To evaluate the efficacy of ovarian stimulation protocols using alpha-follitropin and delta-follitropin in women undergoing IVF treatment, by comparing the number of mature follicles (≥18 mm), the total gonadotropin dose required, and the duration of stimulation in relation to mature oocyte retrieval outcomes.
Methods: The research was conducted with infertile women who underwent in vitro fertilization (IVF) between 2019 and 2024. The study population included women aged 18 to 40 years who underwent ovarian stimulation protocols involving alpha-follitropin or delta-follitropin, either as monotherapy or in combination with other pharmacological agents. Exclusion criteria comprised patients with basal follicle-stimulating hormone (FSH) levels >15 IU/L, antral follicle count (AFC) <3, or a history of ovarian surgery with potential impact on ovarian reserve. A total of 199 patients met the eligibility criteria and were included in the final analysis, providing a statistically robust sample for comparative evaluation. The ovarian stimulation protocols were categorized into four main groups: 1: Delta-follitropin monotherapy, 2: Delta-follitropin combined with menotropin, 3: Alpha-follitropin monotherapy and 4: Alpha-follitropin combined with alpha-lutropin. The following were analyzed as primary outcome was the number of mature oocyte (MII) and as secondary outcomes: mature follicles; total oocytes; induction time and total dose of gonadotropin. Descriptive analyses were performed, with calculation of means, standard deviations, medians and absolute and relative frequencies, non-inferiority test. ANOVA was applied for multigroup comparison between the four induction regimens. Multivariate regression was used to assess the impact of clinical and laboratory variables on the final outcomes.
Results: Regarding the ovarian stimulation protocols, the data demonstrated a relatively uniform distribution across the four evaluated groups. Protocol 3 was the most frequently used, accounting for 27.36% of participants, followed by Protocol 1 (24.88%), Protocol 2 (24.38%), and Protocol 4 (23.38%). The results revealed that the Alfafolitropin + Alfalutropin protocol had a higher mean number of MII oocytes (5.05), indicating greater efficacy in promoting final oocyte maturation. Deltafolitropin alone had the lowest mean number (2.90). Regarding induction time, the Deltafolitropin protocol stood out for its shortest mean time (9.53 days) and lowest variability (standard deviation of 1.69), while the Alfafolitropin + Alfalutropin protocol recorded the longest mean time. Multivariate regression analysis indicated the Trigger as the most relevant variable, exercising a direct impact on the number of mature oocytes found. The total Gonadotropins showed a negative association (coefficient: -0.0010, p = 0.010), indicating that higher doses did not always result in better clinical results. The variables Age, FSH, Estradiol, Induction Time and Induction Scheme did not show a significant association.
Conclusion: The Alfafolitropin + Alfalutropin protocol demonstrated greater potential for improving the final maturation of oocytes, while the Deltafolitropin protocol alone showed less efficacy in this development. The selection of the ideal protocol should be based on a careful evaluation, combined with continuous and individualized monitoring in order to maximize clinical results. It is expected that this work will serve as a subsidy for new studies in the area.