Effect of Recombinant FSH Dosing Following Cori-follitropin Alfa in Patients Undergoing in Vitro Fertilization/Intra-citoplasmatic Sperm Injection: a Randomized Controlled Dose-finding Study.
试验速览
- 阶段
- 不适用
- 入组人数
- 261
- 主要终点
- serum progesterone level on the day of the trigger
研究概览
简要总结
In the trial, women planned to be treated with 150μg corifollitropin alfa followed by rFSH in a fixed GnRH antagonist protocol will be asked to participate and sign the ICF. Corifollitropin alpha treatment will be initiated at D2-D3 of the cycle. Patients who need additional r-FSH following corifollitropin-alfa will be randomized on day 8 of the stimulation into 3 study groups. In group A, B and C, ovarian stimulation with Corifollitropin alfa (Elonva®, MSD) will be used for ovarian stimulation, followed by 50IU (Group A), 150IU (Group B) or 250IU (Group C) of recFSH (Puregon®, MSD).
详细描述
On day 2 or on day 3 of the cycle, blood sampling for estradiol (E2), progesterone (P), follicle stimulating hormone (FSH), luteinising hormone (LH) and human chorionic gonadotropin (hCG) levels, will be per-formed prior to the administration of corifollitropin alfa.
All the blood samples taken during the stimulation for the hormonal profile, starting from day 2, will be performed in a double tube, one for a central assessment and one for the local assessment in order to be used during the monitoring of the cycle. AMH will also be assess on day 2 of the stimulation with a blood sample that will be sent for central assessment.
Administration of the GnRH antagonist ganirelix (Orgalutran®, MSD) will be initiated on day 6 of stimula-tion in all treatment arms at a daily dose of 0.25 mg to prevent a premature LH surge. Suppression with the GnRH antagonist will be continued until the day of final oocyte maturation. Endocrine monitoring and ultrasound scan will be carried out on day 8 of stimulation and repeated every two days until trigger, de-pending on the patients' response. Triggering for final oocyte maturation is performed as soon as 3 follicles of ≥17 mm will be observed.
Cycles will be cancelled if less than 3 follicles of 12 mm are observed on day 8 day of stimulation, nonethe-less, blood test for hormonal evaluation will be performed in any case on day 8.
Oocyte maturation will be triggered with a single subcutaneous injection of hCG (Pregnyl®: 5000UI/sc, MSD, or 10000UI/sc if body weight exceeds 80 kg) as soon as 3 follicles of ≥17 mm will be observed. Ap-proximately 34-36 hours after trigger, oocyte retrieval will be performed. An embryo transfer will be per-formed on day 3 or on day 5 of embryonic development; one or 2 embryos will be replaced.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 38 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Female age: > 18 to < 38 years
- •The patient must have undergone not more than three consecutive unsuccessful IVF/ICSI cycles since the last ongoing pregnancy (whether fresh and/or several frozen ET resulted from these attempts)
- •BMI ≤29 Kg /m2
- •Patients of ≤ 35 years old, body weight should be ≥ 60kg
- •Patients of >35 years old, body weight should be > 50 kg
- •Regular normo-ovulatory menstrual cycles (26-35 days)
- •Basal FSH <10 IU/l, basal E2 <60 pg/ml and basal Progesteone (< 1.5 ng/mL) (normal cycle day-3 basal serum hormone levels), to be measured on cycle day 2 or 3 of the treatment cycle
- •Normal ultrasound scan (presence of both ovaries without evidence of abnormality within 6 months)
- •AFC >7 and < 20
- •No pill within the 3 months before treatment
- •Signed informed consent
排除标准
- •Polycystic ovarian syndrome (PCOS) according to the Rotterdam classification (2004)
- •Oocyte donors
- •Poor responder patients (development of <4 follicles in previous IVF/ICSI or cancelled cycles)
- •Endometriosis ≥ grade 3
- •Contraindications to the use of gonadotropins
- •Abnormal vaginal bleeding of unknown cause
- •History of ovarian hyperstimulation syndrome (OHSS) or a previous ovarian stimulation cycle with more than 30 follicles of 11 mm or higher (as recommended by the Elonva® Summary of Product Characteristics)
- •A history of recurrent miscarriage (three or more consecutive miscarriages)
研究组 & 干预措施
group A
The main difference between the groups is due to the different dose of r-FSH which will be given to pa-tients after the 7 days of CFA; namely that patients who need additional r-FSH following corifollitropin-alfa will be randomized on day 8 of the stimulation into 3 study groups. In group A, B and C, ovarian stimula-tion with Corifollitropin alfa (Elonva®, MSD) will be used for ovarian stimulation, followed by 50IU (Group A).
干预措施: same medications but different dosages (Other)
groppo B
The main difference between the groups is due to the different dose of r-FSH which will be given to pa-tients after the 7 days of CFA; namely that patients who need additional r-FSH following corifollitropin-alfa will be randomized on day 8 of the stimulation into 3 study groups. In group A, B and C, ovarian stimula-tion with Corifollitropin alfa (Elonva®, MSD) will be used for ovarian stimulation, followed by 150IU (Group B)
干预措施: same medications but different dosages (Other)
Group C
The main difference between the groups is due to the different dose of r-FSH which will be given to pa-tients after the 7 days of CFA; namely that patients who need additional r-FSH following corifollitropin-alfa will be randomized on day 8 of the stimulation into 3 study groups. In group A, B and C, ovarian stimula-tion with Corifollitropin alfa (Elonva®, MSD) will be used for ovarian stimulation, followed by 250IU (Group C) of recFSH (Puregon®, MSD).
干预措施: same medications but different dosages (Other)
结局指标
主要结局
serum progesterone level on the day of the trigger
时间窗: 2 years
Compare the mean serum progesterone level (ng/mL) on day of hCG between the study groups.
次要结局
- Clinical pregnancy rate(2 years)
- Number of oocytes retrieved(2 years)
- Miscarriage rate(2 years)
- Number of patients who underwent freeze all the embryos (FA)(2 years)