Kisspeptin shows promise as alternative for IVF treatment

The hormone kisspeptin may be an effective yet safer alternative for triggering oocyte maturation in women undergoing in vitro fertilization than human chorionic gonadotropin, which carries a risk for ovarian hyperstimulation syndrome, according to recent study findings presented at the Society for Endocrinology Annual Conference.

Among a cohort of women treated with kisspeptin-54 before undergoing in vitro fertilization (IVF) treatment, none developed ovarian hyperstimulation syndrome (OHSS), which is estimated to affect 3% to 6% of women treated with human chorionic gonadotropin.

“IVF is an effective therapy for couples affected by infertility, but it can result in OHSS, which is a potentially life-threatening side effect,” Ali Abbara, MBBS, BSc, MRCP, clinical research fellow at Imperial College London, said in a press release. “We have shown that using kisspeptin in place of conventional drugs used during IVF treatment safely matures eggs, even in women at high risk of OHSS.”

In a phase 2, open-label, randomized clinical trial, Abbara and colleagues analyzed data from 60 women at high risk for developing OHSS at the Hammersmith Hospital IVF unit in London. Researchers randomly assigned women to a single injection of various doses of kisspeptin-54 to trigger oocyte maturation. Dose allocations were 3.2 nmol/kg (n = 5), 6.4 nmol/kg (n = 20), 9.6 nmol/kg (n = 15) and 12.8 nmol/kg (n = 20). Researchers retrieved oocytes 36 hours after the kisspeptin-54 doses and assessed them for maturation before they were fertilized by intracytoplasmic sperm injection. Transfer of one or two embryos followed. The women were routinely screened for signs of OHSS; researchers measured oocyte maturation by oocyte yield (percentage of mature oocytes retrieved from follicles > 14 mm on an ultrasound) and measured rates of pregnancy

Oocyte maturation occurred in 95% of women, with the most effective dose, 12.8 nmol/kg, yielding a 121% oocyte yield, 69% greater than the lowest kisspeptin dose.

The biochemical pregnancy rate at all doses of kisspeptin-54 was 63% per transfer; clinical pregnancy rate was 53%; live birth rate was 45%. The highest pregnancy rates were observed after the 9.6-nmol/kg dose, with rates of 85% for biochemical pregnancy, 77% for clinical pregnancy and 62% for live births.

There were no incidents of OHSS, whether moderate, severe or critical, within the cohort, according to researchers.

“Interestingly, our results also suggest that using the best-performing dose of kisspeptin resulted in pregnancy rates almost twice those reported for this age group using conventional stimuli of egg maturation,” Abbara said in a press release. “Kisspeptin appears to be a promising therapy and further studies are now needed to directly compare kisspeptin with currently available IVF treatments.” – by Regina Schaffer

Reference:

Abbara A, et al. Abstract #0159. Presented at: Society for Endocrinology Annual Conference; Nov. 2-4, 2015; Edinburgh, Scotland.

Disclosure: Abbara reports no relevant financial disclosures.