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Randomized Controlled Trial Comparing Embryonic Quality in rFSH Versus hMG in IVF Protocol With GnRH Antagonist

Phase 4
Completed
Conditions
Infertility
Interventions
Drug: rFSH
Registration Number
NCT02412904
Lead Sponsor
Hospital de Clinicas de Porto Alegre
Brief Summary

rFSH and HMG are both used to controlled ovarian stimulation for patients submitted to IVF. However, there is a debate in the literature which one is better to induce ovulation in patients receiving GnRH antagonist to block premature Luteinizing Hormone (LH) secretion.

The investigators propose a Randomized Clinical Trial (RCT) to investigate the differences among recombinant FSH and HMG in patients submitted to IVF using GnRH antagonists.

Detailed Description

To compare embryonic quality and other clinical outcomes when using human menopause gonadotropin (hMG) or recombinant follicle stimulating hormone (rFSH) to the ovarian stimulation in IVF cycles with the GnRH antagonist protocol.

Design: open randomized single center study with infertile patients submitted to IVF comparing IVF outcomes between hMG and rFSH when controlled with GnRH antagonist.

Setting: A single private center of reproductive medicine in association with Universidade Federal do Rio Grande do Sul.

Patients: Infertile women with normal ovarian reserve with IVF indication. Intervention: The patients were randomized in two groups, 85 received rFSH and 83 received hMG to ovulation induction, both groups used GnRH antagonist to prevent ovulation.

Main Outcome Measure: Total embryonic score and best embryonic score. Secondary outcomes: Total dose of gonadotropins, number and size of follicles in the end of the stimulation, number of mature oocytes, number of embryos, pregnancy rates.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
188
Inclusion Criteria
  • 25 to 40 y
  • infertile
  • submitted to IVF
  • no hormonal disease
  • normal FSH (< 10)
  • anti-mullerian hormone (AMH) > 1 ng and < 10 ng
  • both ovaries
  • only first or second IVF
Exclusion Criteria
  • thyroid-stimulating hormone (TSH), prolactin (PRL) altered
  • endometrioma
  • ovarian tumor or cysts
  • previous Ovarian Hyperstimulation Syndrome (OHSS)
  • severe male factor

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
drug to ovulation induction: rFSHrFSHPatients submitted to IVF that will use rFSH (Puregon®, Organon Ltd., Ireland) for ovarian stimulation
drug to ovulation induction :HMGHMGPatients submitted to IVF that will use hMG (Menopur®, Ferring Pharmaceuticals, Denmark) for ovarian stimulation
Primary Outcome Measures
NameTimeMethod
Embryo quality - score of embryo quality in the model od the Graduated Embryo Score (GES)3 to 5 days after the ovarian punction

The embryo evaluation will be performed on day three after fertilization based on the Graduated Embryo Score (GES). It will be performed three evaluations occurring at 16 - 18 hours, 25 - 27 hours and 64 - 67 hours post insemination, by the same embryologist (DS) The score is composed by the following criteria: nucleolar alignment along pronuclear axis, regular cleavage and degree of fragmentation at the first cell division, and cell number and morphology on day 3 after fertilization. The score ranges from 20 to 100 per embryo.

Secondary Outcome Measures
NameTimeMethod
number of follicles graduated by size in groups of 13-14mm; 15-16mm and more than 17mm10 to 13 days after the IVF protocol starts
total number of units of gonadotrophins used to ovarian stimulation10 to 13 days after the IVF protocol starts
number of embryos3 to 5 days after the ovarian punction
number of oocytes retrieved (MII)10 to 13 days after the IVF protocol starts

Trial Locations

Locations (1)

Centro de Reproduçao Humana Insemine

🇧🇷

Porto Alegre, RGS, Brazil

Centro de Reproduçao Humana Insemine
🇧🇷Porto Alegre, RGS, Brazil

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