There is Level 1a evidence that corifollitropin-alpha (Elonva), a sustained-release gonadotropin, is a safe and equally effective alternative treatment to daily FSH injections in good prognosis patients. However, two pilot studies with Elonva in poor responders have shown no clinical benefit. In this observational study we investigated the efficacy and cost-effectiveness of corifollitropin-alpha in the largest cohort of poor responders to date. After adjusting for confounders, there were no differences in the embryo utilisation rate and viable pregnancy rate between the groups. However, the average cost per cycle for the corifollitropin-alpha cycles was markedly less than cycles with daily rFSH injections. This study demonstrated that antagonist cycles with corifollitropin-alpha achieve the same viable pregnancy rates in poor responders as daily FSH injections but at a 35% lower cost to the PBS.
The results for this project were presented at the Fertility Society of Australia annual scientific meeting 2013 and are currently being prepared for publication.