Is there a place for corifollitropin alfa in IVF/ICSI cycles? A systematic review and meta-analysis

29 02 2012

To the Editor:

As the sponsor of all four trials included in a recent systematic review and meta-analysis of corifollitropin alfa, we reviewed the manuscript authored by Youssef and co-workers (1) with great interest. This combined analysis includes two phase II dose-finding trials and two phase III randomized controlled trials.

Related to the OHSS incidence per woman randomized, the authors report on page 3 that the number needed to harm (NNH) is equal to 1. This is an obvious error. If the absolute risk increase is 1% as the authors state, the NNH should have been 100. However, the absolute risk increase is less than 1%. This can be demonstrated by combining the control OHSS rate of 2% (page 3) with the OHSS odds ratio of 1.29 (figure 2C). This gives an Elonva OHSS rate of 2.6%, an increase of 0.6% corresponding to an NNH of 177. In a recent pooled analysis by Tarlatzis (2), only the two phase III randomized controlled trials were included and the odds ratio for OHSS, adjusted for trial, was 1.18 (95%CI 0.81-1.71). Read the rest of this entry »