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CONSORT Randomized Controlled Trial in Assisted Reproductive Technology

Primary Purpose

Infertility

Status
Completed
Phase
Phase 4
Locations
Switzerland
Study Type
Interventional
Intervention
GONAL f® prefilled pen
GONAL f® prefilled pen
Sponsored by
Merck KGaA, Darmstadt, Germany
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Infertility focused on measuring Infertility, Assisted reproductive technology

Eligibility Criteria

18 Years - 34 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Female subjects justifying an in-vitro fertilization (IVF)/embryo transfer (ET) treatment
  2. Have a male partner with semen analysis within the past 6 months prior to randomization considered adequate to proceed with regular insemination or intracytoplasmic sperm injection (ICSI) according to the center's standard practice. If these criteria are not met, the subject can only be entered if donor sperm will be used
  3. Between her 18th and 35th birthday (35 not included) at the time of the randomization visit
  4. Body mass index (BMI) lower than 30 kilogram per square meter (kg/m^2) where the BMI is calculated according to the formula
  5. Have a regular spontaneous ovulatory menstrual cycle between 21 and 35 days in length
  6. Have an early follicular phase (Day 2-4) serum level of basal FSH lower than or equal to 12 International Unit per Liter (IU/L) measured in the center's local laboratory during the screening period (i.e. within 2 months prior to down-regulation start)
  7. Presence of both ovaries
  8. Normal uterine cavity, which in the investigator's opinion is compatible with pregnancy
  9. Have a negative cervical papanicolaou (PAP) test within the last 6 months prior to randomization
  10. Have at least 1 wash-out cycle (defined as greater than or equal to 30 days since the last dose of clomiphene citrate or gonadotrophin treatment) since the last ART cycle and/or clomiphene citrate or gonadotrophin treatment prior to starting gonadotropin releasing hormone (GnRH) agonist therapy
  11. Willing and able to comply with the protocol for the duration of the trial
  12. Have given written informed consent, prior to any trial-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to her future medical care

Exclusion Criteria:

  1. Have greater than or equal to 2 previous ART cycles with a poor response to gonadotrophin stimulation (defined as lower than or equal to 5 mature follicles and/or lower than or equal to 3 oocytes collected) or have greater than or equal to 2 previous ART cycles with a hyper response (defined as greater than or equal to 25 oocytes retrieved)
  2. Any medical condition, which in the judgment of the investigator may interfere with the absorption, distribution, metabolism or excretion of the drug. In case of doubt, the subject in question should be discussed with Merck Serono's Medical responsible
  3. Have previous severe ovarian hyperstimulation syndrome (OHSS)
  4. Polycystic ovary syndrome (PCOS; Rotterdam criteria) to reduce the risk of the occurrence of OHSS
  5. Presence of endometriosis requiring treatment
  6. Uterine myoma requiring treatment
  7. Any contraindication to being pregnant and/or carrying a pregnancy to term
  8. Extra-uterine pregnancy within the last 3 months prior to screening
  9. History of 3 or more miscarriages (early or late miscarriages) due to any cause
  10. Tumors of the hypothalamus and pituitary gland
  11. Ovarian enlargement or cyst of unknown etiology
  12. Ovarian, uterine or mammary cancer
  13. A clinically significant systemic disease
  14. Known infection with Human Immunodeficiency Virus (HIV), Hepatitis B or C virus in the trial subject or her male partner,
  15. Abnormal gynecological bleeding of undetermined origin
  16. Known allergy or hypersensitivity to human gonadotrophin preparations,
  17. Any active substance abuse or history of drug medication or alcohol abuse in the past 5 years prior to the screening visit
  18. Entered previously into this trial or simultaneous participation in another clinical trial

Sites / Locations

  • Research Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

CONSORT Dosing

Standard Dosing

Arm Description

GONAL-f® dose based on subject baseline characteristics determined according to the CONSORT calculator

GONAL-f® at a standard dose of 150 IU per day

Outcomes

Primary Outcome Measures

Number of Oocytes Retrieved Per Participant
Mean number of oocytes retrieved on the day of ovum pick up (OPU) was calculated. Oocyte retrieval is a technique used in in-vitro fertilization in order to remove oocytes from the ovary of the female, enabling fertilization outside the body.

Secondary Outcome Measures

Total GONAL-f® Dose
Mean GONAL-f® Daily Dose
Total Number of GONAL-f® Stimulation Treatment Days
Number of Participants With Cancelled Cycles Due to Excessive or Inadequate Response to Treatment
Number of participants with cancelled cycles due to excessive or inadequate response was evaluated. An excessive response: greater than or equal to 25 oocytes which could put the participant at risk of OHSS; An inadequate response: defined as 3 or less follicles of greater than or equal to 12 millimeter (mm) developing following at least 7 days of GONAL-f® treatment.
Percentage of Participants With Biochemical Pregnancies
Biochemical pregnancy was defined as a pregnancy diagnosed only by the detection of hCG in serum and that does not develop into a clinical pregnancy.
Number of Participants With Fetal Sacs and Fetal Hearts
Number of participants with fetal sacs and fetal hearts (with activity) as seen on an ultrasound scan to confirm clinical pregnancy.
Implantation Rate
Implantation rate was measured as the number of gestational sacs observed divided by the number of embryos transferred multiplied by 100.
Number of Participants With Multiple Pregnancies
Multiple pregnancy was defined as 2 or more fetal hearts with activity.
Serum Progesterone (P4) Levels
Percentage of Participants With Clinical Pregnancy
Clinical pregnancy is defined by the number of sacs and hearts with activity per ultrasound scan performed on Day 35-42 post-hCG.
Number of Participants With OHSS
OHSS is a syndrome which can manifest with enlarged ovaries, advanced ascites with increased vascular permeability, pleural fluid accumulation, hemoconcentration, and increased blood clotting.
Pregnancy Outcome - Number of Participants With Pregnancy and Their Outcome
Pregnancy outcomes are live outcome (live infant) and non-live outcome (non-live infant) or unknown outcome (subject lost to follow-up).

Full Information

First Posted
January 22, 2009
Last Updated
January 20, 2014
Sponsor
Merck KGaA, Darmstadt, Germany
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1. Study Identification

Unique Protocol Identification Number
NCT00829244
Brief Title
CONSORT Randomized Controlled Trial in Assisted Reproductive Technology
Official Title
A Phase IV Prospective, Multicenter, Randomized, Open-label Trial to Assess the Efficacy and Safety of GONAL f® at a Dose Based on Subject Baseline Characteristics Determined According to the CONSORT Calculator Compared With a Standard Dose of GONAL f® 150 IU Per Day for Ovarian Stimulation in Women Undergoing Assisted Reproductive Technology (ART)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2014
Overall Recruitment Status
Completed
Study Start Date
August 2008 (undefined)
Primary Completion Date
January 2010 (Actual)
Study Completion Date
January 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Merck KGaA, Darmstadt, Germany

4. Oversight

5. Study Description

Brief Summary
The overall objective of this trial is to compare the ovarian response in assisted reproductive technology (ART) subjects administered GONAL f® according to the 'Consistency in recombinant follicle stimulating hormone [r-FSH] starting doses for individualized treatment' (CONSORT) calculator versus given a standard GONAL f® dose of 150 International Unit (IU) per day.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infertility
Keywords
Infertility, Assisted reproductive technology

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
200 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CONSORT Dosing
Arm Type
Experimental
Arm Description
GONAL-f® dose based on subject baseline characteristics determined according to the CONSORT calculator
Arm Title
Standard Dosing
Arm Type
Active Comparator
Arm Description
GONAL-f® at a standard dose of 150 IU per day
Intervention Type
Drug
Intervention Name(s)
GONAL f® prefilled pen
Other Intervention Name(s)
Follitropin alfa, Recombinant human follicle stimulating hormone (r-hFSH), GONAL-f® Prefilled Pen
Intervention Description
GONAL f® doses starting at minimum of 112.5 IU per day and a maximum of 450 IU per day for 1 cycle only
Intervention Type
Drug
Intervention Name(s)
GONAL f® prefilled pen
Other Intervention Name(s)
Follitropin alfa, r-hFSH, GONAL-f® Prefilled Pen
Intervention Description
GONAL f® standard treatment arm (150 IU of GONAL f® per day) up to Day 5 of stimulation after which the dose can be adjusted based upon the subject's ovarian response and according to the center's standard practice.
Primary Outcome Measure Information:
Title
Number of Oocytes Retrieved Per Participant
Description
Mean number of oocytes retrieved on the day of ovum pick up (OPU) was calculated. Oocyte retrieval is a technique used in in-vitro fertilization in order to remove oocytes from the ovary of the female, enabling fertilization outside the body.
Time Frame
34-38 hours post-recombinant human choriogonadotropin (hCG) (OPU)
Secondary Outcome Measure Information:
Title
Total GONAL-f® Dose
Time Frame
Start of treatment until end of stimulation cycle (approximately 28 days)
Title
Mean GONAL-f® Daily Dose
Time Frame
Start of treatment until end of stimulation cycle (approximately 28 days)
Title
Total Number of GONAL-f® Stimulation Treatment Days
Time Frame
Start of treatment until end of stimulation cycle (approximately 28 days)
Title
Number of Participants With Cancelled Cycles Due to Excessive or Inadequate Response to Treatment
Description
Number of participants with cancelled cycles due to excessive or inadequate response was evaluated. An excessive response: greater than or equal to 25 oocytes which could put the participant at risk of OHSS; An inadequate response: defined as 3 or less follicles of greater than or equal to 12 millimeter (mm) developing following at least 7 days of GONAL-f® treatment.
Time Frame
Start of treatment until Day 15-20 post-hCG
Title
Percentage of Participants With Biochemical Pregnancies
Description
Biochemical pregnancy was defined as a pregnancy diagnosed only by the detection of hCG in serum and that does not develop into a clinical pregnancy.
Time Frame
Start of treatment until Day 15-20 Post-hCG
Title
Number of Participants With Fetal Sacs and Fetal Hearts
Description
Number of participants with fetal sacs and fetal hearts (with activity) as seen on an ultrasound scan to confirm clinical pregnancy.
Time Frame
Day 35-42 Post-hCG
Title
Implantation Rate
Description
Implantation rate was measured as the number of gestational sacs observed divided by the number of embryos transferred multiplied by 100.
Time Frame
Day 35-42 Post-hCG
Title
Number of Participants With Multiple Pregnancies
Description
Multiple pregnancy was defined as 2 or more fetal hearts with activity.
Time Frame
Day 35-42 Post-hCG
Title
Serum Progesterone (P4) Levels
Time Frame
End of stimulation cycle (approximately 28 days)
Title
Percentage of Participants With Clinical Pregnancy
Description
Clinical pregnancy is defined by the number of sacs and hearts with activity per ultrasound scan performed on Day 35-42 post-hCG.
Time Frame
Day 35-42 Post-hCG
Title
Number of Participants With OHSS
Description
OHSS is a syndrome which can manifest with enlarged ovaries, advanced ascites with increased vascular permeability, pleural fluid accumulation, hemoconcentration, and increased blood clotting.
Time Frame
Start of treatment until Day 15-20 Post-hCG
Title
Pregnancy Outcome - Number of Participants With Pregnancy and Their Outcome
Description
Pregnancy outcomes are live outcome (live infant) and non-live outcome (non-live infant) or unknown outcome (subject lost to follow-up).
Time Frame
up to 9 month (following the end of treatment)

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
34 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female subjects justifying an in-vitro fertilization (IVF)/embryo transfer (ET) treatment Have a male partner with semen analysis within the past 6 months prior to randomization considered adequate to proceed with regular insemination or intracytoplasmic sperm injection (ICSI) according to the center's standard practice. If these criteria are not met, the subject can only be entered if donor sperm will be used Between her 18th and 35th birthday (35 not included) at the time of the randomization visit Body mass index (BMI) lower than 30 kilogram per square meter (kg/m^2) where the BMI is calculated according to the formula Have a regular spontaneous ovulatory menstrual cycle between 21 and 35 days in length Have an early follicular phase (Day 2-4) serum level of basal FSH lower than or equal to 12 International Unit per Liter (IU/L) measured in the center's local laboratory during the screening period (i.e. within 2 months prior to down-regulation start) Presence of both ovaries Normal uterine cavity, which in the investigator's opinion is compatible with pregnancy Have a negative cervical papanicolaou (PAP) test within the last 6 months prior to randomization Have at least 1 wash-out cycle (defined as greater than or equal to 30 days since the last dose of clomiphene citrate or gonadotrophin treatment) since the last ART cycle and/or clomiphene citrate or gonadotrophin treatment prior to starting gonadotropin releasing hormone (GnRH) agonist therapy Willing and able to comply with the protocol for the duration of the trial Have given written informed consent, prior to any trial-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to her future medical care Exclusion Criteria: Have greater than or equal to 2 previous ART cycles with a poor response to gonadotrophin stimulation (defined as lower than or equal to 5 mature follicles and/or lower than or equal to 3 oocytes collected) or have greater than or equal to 2 previous ART cycles with a hyper response (defined as greater than or equal to 25 oocytes retrieved) Any medical condition, which in the judgment of the investigator may interfere with the absorption, distribution, metabolism or excretion of the drug. In case of doubt, the subject in question should be discussed with Merck Serono's Medical responsible Have previous severe ovarian hyperstimulation syndrome (OHSS) Polycystic ovary syndrome (PCOS; Rotterdam criteria) to reduce the risk of the occurrence of OHSS Presence of endometriosis requiring treatment Uterine myoma requiring treatment Any contraindication to being pregnant and/or carrying a pregnancy to term Extra-uterine pregnancy within the last 3 months prior to screening History of 3 or more miscarriages (early or late miscarriages) due to any cause Tumors of the hypothalamus and pituitary gland Ovarian enlargement or cyst of unknown etiology Ovarian, uterine or mammary cancer A clinically significant systemic disease Known infection with Human Immunodeficiency Virus (HIV), Hepatitis B or C virus in the trial subject or her male partner, Abnormal gynecological bleeding of undetermined origin Known allergy or hypersensitivity to human gonadotrophin preparations, Any active substance abuse or history of drug medication or alcohol abuse in the past 5 years prior to the screening visit Entered previously into this trial or simultaneous participation in another clinical trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pablo Arriagada, MD
Organizational Affiliation
Merck Serono S.A., Geneva
Official's Role
Study Director
Facility Information:
Facility Name
Research Site
City
Geneva
Country
Switzerland

12. IPD Sharing Statement

Citations:
PubMed Identifier
25596910
Citation
Olivennes F, Trew G, Borini A, Broekmans F, Arriagada P, Warne DW, Howles CM. Randomized, controlled, open-label, non-inferiority study of the CONSORT algorithm for individualized dosing of follitropin alfa. Reprod Biomed Online. 2015 Mar;30(3):248-57. doi: 10.1016/j.rbmo.2014.11.013. Epub 2014 Dec 15.
Results Reference
derived

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CONSORT Randomized Controlled Trial in Assisted Reproductive Technology

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