JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):184
Poster Presentation
29th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263904
P-172. Patterns of use of Follitropin Delta in Assisted Reproduction in Brazil: A Real-World Observational Study
João A Dias-Jr1, Roberto De Azevedo Antunes2, Carlos Roberto Izzo1, Geroges Fassolas1, Luis Fernando Henrique1, Luciana Carvalho Delamuta1, Lucas Yugo Shigehara Yamakami3, Renato Bussadori Tomioka3, Larissa Matsumoto3, Fernanda Imperial Carneiro Liez3, Maria do Carmo Borges de Souza2, Marcelo Marinho de Souza2, Karina Abelha Rabaço2, Ana Cristina Allemand Mancebo2, Edson Borges-Jr4, Daniela Braga4, Maite Del Collado4, Caio Parente Barbosa5, Emerson Barchi Cordts5, Ivan Henrique Yoshida5, Oscar Duarte3
1 Clínica Originare - Medicina Reprodutiva - São Paulo - SP - Brasil
2 Fertipraxis – Centro de Reprodução Humana - Rio de Janeiro - RJ – Brasil
3 Vida Bem Vinda Medicina Reprodutiva - São Paulo - SP - Brasil
4 Fertility Medical Group - São Paulo - SP - Brasil
5 Ideia Fertil - São Paulo - SP - Brasil
Objective: To evaluate the real-world usage patterns of follitropin delta (FD) in assisted reproductive treatments in Brazil and the main patient outcomes.
Methods: This multicenter, retrospective, observational study analyzed 2284 patients that used FD, undergoing 2872 cycles of ovarian stimulation for ART (1875 IVF, 841 oocyte cryopreservation, 156 oocyte donation) between April 2018 and December 2023 in five Brazilian assisted reproduction clinics. The study evaluated demographic variables, algorithm adherence, dose of FD, type and dose of drugs added to FD, pituitary suppression, trigger protocols, and ART outcomes in these first-time FD cycles. Descriptive statistics were used for all outcomes. Analysis was performed using the Statistical Package for the Social Sciences (SPSS) Statistics 21 (IBM, New York, New York, USA).
Results: Among 2872 cycles, 79.5% (2284/2872) were of first-time FD users, while 20.5% (588/2872) underwent multiple cycles (mean 1.32±0.78). Among the 2284 first-time FD ART cycles, 705 were for oocyte cryopreservation, 131 involved oocyte donation, and 1448 were IVF cycles. The mean patient's age and weight were 36.2±4.3 years and 64.711.1 kg. Mean AMH was 2.3±2.6ng/mL (1687 patients). Only 1.9% (43) followed the algorithm (Protocol 1); 98.1% (2241) used alternative regimens: monotherapy without algorithm (Protocol 2:14.8%, n=338), FD+menotropin (Protocol 3:75.3%, n=1719), FD+Recombinant FSH+LH (Protocol 4:5%, n=114) or other protocols (3%, n=70). Mean FD starting and total doses: Protocol 1 (8.7±2.1mcg; 83.7±20.1mcg), Protocol 2 (12.3±3.0mcg; 116.4±33.0mcg), Protocol 3 (9.9±2.5mcg; 93.2±26.8mcg), Protocol 4 (11.0±2.1mcg; 112.4±31.5mcg), and other protocols (10.5±4.3mcg; 106.7±44.5mcg). Pituitary suppression included flexible antagonists (49.2%), progesterone (45.8%), others (5%). Cycle cancellation occurred before oocyte pick-up (OPU) due to low ovarian response in 121 cycles (5.3%), being 36, 4 and 81 in oocyte cryopreservation, oocyte donors and IVF, respectively. Ovulation was triggered in 2163 (94.7%) patients with agonist (47.7%), hCG (11%), or dual trigger (41.3%). Mean retrieved oocytes and MII were 12.9±9.5 and 9.7±7.3, respectively. Among 1448 IVF patients, 1367 underwent OPU. Fertilization, cleavage, and blastocyst formation rates: 74%, 94.7%, 49.9%. PGT was performed in 66.2% (905); Ongoing pregnancy rate (20 weeks) per transfer: 47.9% (PGT) and 34.2% (non-PGT). Take-home baby rate per initiated cycle: 36.5% after up to 4 transfers. Severe OHSS: 0.1% (4 cases).
Conclusion: Follitropin delta demonstrated to be safe and efficient across diverse clinical regimens adding new findings from other published studies.