Outcomes of ICSI in a Study Comparing HP hMG and r-hFSH

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Hans van der Slikke, MD, PhD: “It’s January of 2002, and we’re in Fort Lauderdale, Florida at the Advances in Infertility Treatment Conference. Next to me is Dr. Kilani - welcome, Dr. Kilani.” 

Ziad Kilani, MD: “Thank you.” 

Hans van der Slikke, MD, PhD: “You are from Jordan, and you did a presentation about the results of a trial between rec FSH and urinary hMG in ICSI patients.” 

Ziad Kilani, MD: “That’s right.” 

Hans van der Slikke, MD, PhD: “You did the study together with Marco Filicori from Bologna. Can you please tell us what the idea was for doing this study?” 

Ziad Kilani, MD: “In infertility this branch is progressing very, very fast and very often we have new drugs coming up. We have to decide what to choose and what’s the best for our patients. I come from a part of the world where we have to be careful with the cost of medicine and of course safety and the effect of the medicine. Every time we have a new drug my colleagues and myself with some other group outside in Europe, for example, in this occasion we were involved with an Italian group - Dr. Filicori, we studied and evaluated this new brand of medicine. Is it effective, is it cost-effective, and is it useful like another drug that is well established or not? That’s what I have done with my group and we found that this new medicine is indeed as good as a very well established brand of medicine but has a major advantage, we hope, it will be more cost-effective which is very important for our part of the world.” 

Hans van der Slikke, MD, PhD: “It costs less, so you did a study - how many cycles did you have in every arm?” 

Ziad Kilani, MD: “We had 100 patients, 50 in each arm and we compared it altogether under the same circumstances and it was a blind study, we did not know which was which. We found at the end that both groups had almost the same results but if we compared the cost of the trial we found less in the highly purified group because the duration of treatment was less which is very important, mind you, because we have a lot of patients that come from outside Jordan. From the whole region, 80% of our patients come from outside Jordan so the duration of stay in the country is less and the number of ampules used was less.” 

Hans van der Slikke, MD, PhD: “And the price of each ampule?” 

Ziad Kilani, MD: “It was less.” 

Hans van der Slikke, MD, PhD: “How many days earlier were you at the point of being able to administer hCG?” 

Ziad Kilani, MD: “About three days difference.” 

Hans van der Slikke, MD, PhD: “Three days.” 

Ziad Kilani, MD: “Yes, which is very important.” 

Hans van der Slikke, MD, PhD: “One of the other endpoints was the number of pregnancies.” 

Ziad Kilani, MD: “The number of pregnancies was equal or comparable, and we transferred few embryos. We don’t like to transfer many because this is a policy of my unit, we don’t like multiple pregnancies. We are not proud to have triplets, quadruplets, quintuplets, and so on.” 

Hans van der Slikke, MD, PhD: “How many embryos did you transfer?” 

Ziad Kilani, MD: “Most the patients had one or two embryos and even then we had a very high success rate, over 30% of pregnancies, and the expected take-home baby rate will be over 25% which is a very reasonable rate.” 

Hans van der Slikke, MD, PhD: “But you had a very young group in your patients, correct?” 

Ziad Kilani, MD: “Yes.” 

Hans van der Slikke, MD, PhD: “The oldest was 36?” 

Ziad Kilani, MD: “That’s right, the mean age was 37 years.” 

Hans van der Slikke, MD, PhD: “So altogether you found a number of advantages, so your advice is to use the urinary product instead of the recombinant.” 

Ziad Kilani, MD: “Yes, my first choice would be the urinary product mainly because of the cost-effectiveness 

Hans van der Slikke, MD, PhD: “Thank you very much for this interview.” 

Ziad Kilani, MD: “Thank you.”