Pulsatile rFSH partially improves fertility, pregnancy outcomes in women with obesity

Intravenous administration of pulsatile recombinant FSH (rFSH) in women helps reverse some of the negative effects of high body mass index (BMI) on fertility, assisted reproduction, and pregnancy outcomes, according to a study.

The prospective interventional study included 27 women with normal weight (control) and 27 women with obesity. All of them had normal or regular menstruation, with the age range between 21 and 39 years, and underwent a modified GnRH antagonism intervention protocol. The protocol involved cetrorelix suppression of gonadotropins and exogenous pulsatile intravenous rFSH treatment.

Researchers conducted a 2-day frequent blood sampling study in early follicular phase, before and after the intervention.

The intervention led to effective suppression of endogenous gonadotropin production in women in the obesity and control groups, which provided a model to address the functional role of FSH in the hypothalamic-pituitary-ovarian axis. Moreover, serum levels and pharmacodynamics following intravenous rFSH treatment were similar in both the obesity and control groups.

However, the obesity group showed reduced basal levels of inhibin B and estradiol levels–the primary outcome–and diminished response to FSH stimulation as compared with the control group. Further analysis confirmed that BMI was inversely correlated with serum inhibin B and estradiol.

Despite the seen deficit in ovarian function in women with obesity, the levels of estradiol and inhibin B after pulsatile intravenous rFSH treatment were comparable to those observed in normal weight women in the absence of exogenous FSH stimulation.