Needle-Free Device Enables Hormone 'Injection' for IVF

Laurie Barclay, MD

July 08, 2002

July 8, 2002 — The J-Tip, a needle-free device using compressed carbon dioxide to propel gonadotropins through the skin, was well-tolerated by women undergoing in vitro fertilization (IVF) and was successful in stimulating eggs for collection and subsequent pregnancies, according to a presentation July 3 at the European Society of Human Reproduction and Embryology annual meeting in Vienna, Austria.

"The development of a needle-free injection system is an important target in the improvement of patient convenience in IVF, where the drug treatment phase can require daily injections for several weeks, which for many can be a stressful experience, particularly for those who have a fear of needles," lead author Stuart Lavery, from the Hammersmith Hospital in London, England, says in a news release. "Although nurses administered the J-Tip injections, the ultimate aim is for the patients to be able to do it themselves."

The J-Tip is a single-use, disposable device about 10-cm long that uses a compressed carbon dioxide gas cartridge to propel liquid medication under high pressure through the skin into the subcutaneous layer.

In this study, 20 patients aged 20 to 38 years underwent controlled ovarian hyperstimulation with recombinant follicle stimulating hormone (rFSH) administered through the J-Tip, as well as a GnRH antagonist. Of 20 patients recruited, 16 reached the stage of egg collection, one patient was canceled due to poor response, one was canceled due to the number of technically incorrect J-Tip injections, and two withdrew at their own request.

"Diaries kept by patients during their treatment indicated a high level of patient acceptance of the J-Tip," Lavery says. "All the women had undergone conventional IVF cycles previously and their diaries indicate a clear preference for the needle-free approach."

Over a mean of 10 days, the mean dose of rFSH administered was 1,618 IU, and the mean number of eggs collected was 12. Of 256 injections administered, 46 (18%) were technically incorrect. Clinical pregnancy occurred in four (25%) of the 16 patients who reached the stage of egg collection. Patient diaries reported a high level of acceptance, but the authors indicated that this technique may require further modification to decrease the number of technically incorrect injections.

"This is the first time that the J-Tip has been used in reproductive medicine and we can report the first pregnancies achieved using this system," Lavery says. "The results in this small study were reassuringly comparable with conventional techniques in terms of number of eggs collected and pregnancy rates. The study shows that the J-Tip is capable of delivering hormones in a new and less invasive way."

ESHRE Annual Meeting: Abstract O-203. July 3, 2002.

Reviewed by Gary D. Vogin, MD

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