U.S. REAL-WORLD PRESCRIBING PATTERNS OF MIXED GONADOTROPIN OVARIAN STIMULATION PROTOCOLS: A CLAIMS-BASED ANALYSIS
Author(s)
Kinsuk Chauhan, MD, MPH1, Udit R, MBA1, Wei Zhou, MD, PhD1, Dana Chuderland Ben Arie, PhD2, Katie Barletta, MD, PhD1;
1Ferring Pharmaceuticals Inc., Parsippany, NJ, USA, 2Ferring Pharmaceuticals Ltd., West Drayton, United Kingdom
1Ferring Pharmaceuticals Inc., Parsippany, NJ, USA, 2Ferring Pharmaceuticals Ltd., West Drayton, United Kingdom
OBJECTIVES: Real-world evidence describing gonadotropin prescribing patterns in assisted reproductive technology (ART) remains limited. Mixed ovarian stimulation protocols combining highly purified human menopausal gonadotropin (HP-hMG; menotropin, 1:1 FSH:LH bioactivity) with recombinant follicle-stimulating hormone (rFSH) are widely used, yet longitudinal data describing prescribing trends and relative FSH and LH bioactivity exposure are sparse. This study evaluated U.S. real-world prescribing patterns for mixed gonadotropin ovarian stimulation protocols.
METHODS: A retrospective observational study was conducted using the IQVIA Longitudinal Access and Adjudicated Data (LAAD) claims database (~65% U.S. coverage). Women initiating gonadotropin therapy between 2019-2025 were identified using pharmacy and procedure claims related to ovarian stimulation. Treatment cycles were defined as a 30-day window following gonadotropin prescription. Mixed protocols were defined as cycles with prescriptions for both menotropin and rFSH within the same cycle. Annual trends were summarized descriptively at the cycle level. Total prescribed vials per cycle were normalized to 75-IU equivalents to enable standardized comparisons. Results reflect prescribed quantities only.
RESULTS: The study population included 935,610 women with a mean age of 36 years and an average of 1.3 stimulation cycles per year. Mixed gonadotropin protocols represented the predominant prescribing strategy (N=604,643), increasing from 52% to 70% of all stimulation cycles between 2019 and 2025. Among mixed protocols, a mean of 21 menotropin 75-IU-equivalent vials and 40 rFSH 75-IU-equivalent vials were prescribed per cycle. Based on labeled gonadotropin bioactivity, this corresponds to an approximate 3:1 ratio of FSH-to-LH bioactivity across the stimulation course.
CONCLUSIONS: U.S. prescription claims demonstrate that mixed ovarian stimulation protocols combining menotropin and rFSH predominate and continue to increase over time. Prescribed vial patterns consistently reflect greater relative FSH compared with LH bioactivity (~3:1), highlighting clinician preferences in mixed-protocol design. Mixed-protocol utilization may be underestimated, as cycles paid fully out-of-pocket are not captured in claims data.
METHODS: A retrospective observational study was conducted using the IQVIA Longitudinal Access and Adjudicated Data (LAAD) claims database (~65% U.S. coverage). Women initiating gonadotropin therapy between 2019-2025 were identified using pharmacy and procedure claims related to ovarian stimulation. Treatment cycles were defined as a 30-day window following gonadotropin prescription. Mixed protocols were defined as cycles with prescriptions for both menotropin and rFSH within the same cycle. Annual trends were summarized descriptively at the cycle level. Total prescribed vials per cycle were normalized to 75-IU equivalents to enable standardized comparisons. Results reflect prescribed quantities only.
RESULTS: The study population included 935,610 women with a mean age of 36 years and an average of 1.3 stimulation cycles per year. Mixed gonadotropin protocols represented the predominant prescribing strategy (N=604,643), increasing from 52% to 70% of all stimulation cycles between 2019 and 2025. Among mixed protocols, a mean of 21 menotropin 75-IU-equivalent vials and 40 rFSH 75-IU-equivalent vials were prescribed per cycle. Based on labeled gonadotropin bioactivity, this corresponds to an approximate 3:1 ratio of FSH-to-LH bioactivity across the stimulation course.
CONCLUSIONS: U.S. prescription claims demonstrate that mixed ovarian stimulation protocols combining menotropin and rFSH predominate and continue to increase over time. Prescribed vial patterns consistently reflect greater relative FSH compared with LH bioactivity (~3:1), highlighting clinician preferences in mixed-protocol design. Mixed-protocol utilization may be underestimated, as cycles paid fully out-of-pocket are not captured in claims data.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD94
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Reproductive & Sexual Health