Supplementation With Human Chorionic Gonadotropin (hCG) During Controlled Ovarian Stimulation With Recombinant Follicle-stimulating Hormone (FSH) for In Vitro Fertilisation
Primary Purpose
Infertility
Status
Completed
Phase
Phase 4
Locations
Denmark
Study Type
Interventional
Intervention
rFSH
human chorionic gonadotropin
human chorionic gonadotropin
human chorionic gonadotropin
Sponsored by
About this trial
This is an interventional treatment trial for Infertility focused on measuring hCG, human chorionic gonadotropin
Eligibility Criteria
Inclusion Criteria:
- Females with indication for COS and IVF;
- Age between 25-37 years;
- BMI >18 and < 30 kg/m2;
- A regular menstrual cycle between 24 and 35 days and presumed to be ovulatory;
- Two ovaries;
- Tubal or unexplained infertility, including endometriosis stage I/II;
- A uterus consistent with expected normal function (e.g. no clinically interfering uterine fibroids) documented by transvaginal ultrasound at the screening;
- Male partner with sperm quality compatible with fertilization via IVF procedure or previous clinical pregnancy;
- Early follicular phase serum FSH levels of 1-12 IU/l;
- Early follicular phase total antral follicle (2-10mm) count ≥ 6;
- Confirmation of down-regulation before randomisation by transvaginal ultrasound;
- Willing and able to sign informed consent.
Exclusion Criteria:
- History of or current PCOS, endometriosis stage III/IV or severe male factor requiring ICSI;
- History of severe ovarian hyperstimulation syndrome (OHSS);
- Presence of unilateral or bilateral hydrosalpinx at ultrasound;
- More than three previously COS cycles;
- Previous poor response on an IVF-cycle, defined as >20 days of gonadotrophin stimulation, cancellation due to limited follicular response or less than four follicles of ³15 mm diameter;
- Previous IVF cycle with unsuccessful fertilization, defined as fertilisation of £20% of the retrieved oocytes;
- History of recurrent miscarriage;
- FSH>12IU/L or LH>12UI/L (early follicular phase);
- Contraindications for the use of gonadotropins or GnRH analogues;
- Recent history of current epilepsy, HIV infection, diabetes or cardiovascular gastrointestinal, hepatic, renal or pulmonary disease;
- Pregnancy, lactation or contraindication to pregnancy;
- Current past (last 12 months) abuse of alcohol or drugs;
- History of chemotherapy (except for gestational conditions) of radiotherapy;
- Undiagnosed vaginal bleeding;
- Tumours of the ovary, breast, adrenal gland, pituitary or hypothalamus and malformation of sexual organs incompatible with pregnancy;
- Abnormal karyotyping of the patient (if karyotyping is performed);
- Hypersensitivity to any trial product.
Sites / Locations
- The Fertility Clinic, Rigshospitalet
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Active Comparator
Experimental
Experimental
Experimental
Arm Label
Control arm
hCG low dose
hCG medium dose
hCG high dose
Arm Description
150 iu/day of rFSH alone
150 iu/day of rFSH + 50 iu/day of hCG from stimulation day 1
150 iu/day of rFSH + 100 iu/day of hCG from stimulation day 1
150 iu/day of rFSH + 150 iu/day of hCG from stimulation day 1
Outcomes
Primary Outcome Measures
Total number of top-quality embryos at day 3
Secondary Outcome Measures
Implantation rate; Dose of rFSH needed; Serum levels of endocrine parameters; Ongoing pregnancy; Follicular fluid levels of endocrine parameters and cytokines; Expressions of gene families in granulosa cells and the cumulus complex.
Full Information
NCT ID
NCT00844311
First Posted
February 13, 2009
Last Updated
August 3, 2010
Sponsor
Rigshospitalet, Denmark
1. Study Identification
Unique Protocol Identification Number
NCT00844311
Brief Title
Supplementation With Human Chorionic Gonadotropin (hCG) During Controlled Ovarian Stimulation With Recombinant Follicle-stimulating Hormone (FSH) for In Vitro Fertilisation
Official Title
Supplementation With hCG During Controlled Ovarian Stimulation With Recombinant FSH for in Vitro Fertilisation. A Randomized Controlled Clinical Study. Clinical, Embryological, Endocrine and Genetic Aspects.
Study Type
Interventional
2. Study Status
Record Verification Date
February 2009
Overall Recruitment Status
Completed
Study Start Date
February 2009 (undefined)
Primary Completion Date
June 2010 (Actual)
Study Completion Date
June 2010 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
Rigshospitalet, Denmark
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this trial is to study whether addition of different doses of human chorionic gonadotropins during controlled ovarian stimulation for patients undergoing IVF will improve the number of top-quality embryos.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infertility
Keywords
hCG, human chorionic gonadotropin
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
60 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Control arm
Arm Type
Active Comparator
Arm Description
150 iu/day of rFSH alone
Arm Title
hCG low dose
Arm Type
Experimental
Arm Description
150 iu/day of rFSH + 50 iu/day of hCG from stimulation day 1
Arm Title
hCG medium dose
Arm Type
Experimental
Arm Description
150 iu/day of rFSH + 100 iu/day of hCG from stimulation day 1
Arm Title
hCG high dose
Arm Type
Experimental
Arm Description
150 iu/day of rFSH + 150 iu/day of hCG from stimulation day 1
Intervention Type
Drug
Intervention Name(s)
rFSH
Intervention Description
150 iu/day of rFSH
Intervention Type
Drug
Intervention Name(s)
human chorionic gonadotropin
Intervention Description
50 iu/day of hCG from stimulation day 1
Intervention Type
Drug
Intervention Name(s)
human chorionic gonadotropin
Intervention Description
100 iu/day of hCG from stimulation day 1
Intervention Type
Drug
Intervention Name(s)
human chorionic gonadotropin
Intervention Description
150 iu/day of hCG from stimulation day 1
Primary Outcome Measure Information:
Title
Total number of top-quality embryos at day 3
Secondary Outcome Measure Information:
Title
Implantation rate; Dose of rFSH needed; Serum levels of endocrine parameters; Ongoing pregnancy; Follicular fluid levels of endocrine parameters and cytokines; Expressions of gene families in granulosa cells and the cumulus complex.
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
37 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Females with indication for COS and IVF;
Age between 25-37 years;
BMI >18 and < 30 kg/m2;
A regular menstrual cycle between 24 and 35 days and presumed to be ovulatory;
Two ovaries;
Tubal or unexplained infertility, including endometriosis stage I/II;
A uterus consistent with expected normal function (e.g. no clinically interfering uterine fibroids) documented by transvaginal ultrasound at the screening;
Male partner with sperm quality compatible with fertilization via IVF procedure or previous clinical pregnancy;
Early follicular phase serum FSH levels of 1-12 IU/l;
Early follicular phase total antral follicle (2-10mm) count ≥ 6;
Confirmation of down-regulation before randomisation by transvaginal ultrasound;
Willing and able to sign informed consent.
Exclusion Criteria:
History of or current PCOS, endometriosis stage III/IV or severe male factor requiring ICSI;
History of severe ovarian hyperstimulation syndrome (OHSS);
Presence of unilateral or bilateral hydrosalpinx at ultrasound;
More than three previously COS cycles;
Previous poor response on an IVF-cycle, defined as >20 days of gonadotrophin stimulation, cancellation due to limited follicular response or less than four follicles of ³15 mm diameter;
Previous IVF cycle with unsuccessful fertilization, defined as fertilisation of £20% of the retrieved oocytes;
History of recurrent miscarriage;
FSH>12IU/L or LH>12UI/L (early follicular phase);
Contraindications for the use of gonadotropins or GnRH analogues;
Recent history of current epilepsy, HIV infection, diabetes or cardiovascular gastrointestinal, hepatic, renal or pulmonary disease;
Pregnancy, lactation or contraindication to pregnancy;
Current past (last 12 months) abuse of alcohol or drugs;
History of chemotherapy (except for gestational conditions) of radiotherapy;
Undiagnosed vaginal bleeding;
Tumours of the ovary, breast, adrenal gland, pituitary or hypothalamus and malformation of sexual organs incompatible with pregnancy;
Abnormal karyotyping of the patient (if karyotyping is performed);
Hypersensitivity to any trial product.
Facility Information:
Facility Name
The Fertility Clinic, Rigshospitalet
City
Copenhagen
ZIP/Postal Code
KBH O
Country
Denmark
12. IPD Sharing Statement
Citations:
PubMed Identifier
24297796
Citation
Thuesen LL, Andersen AN, Loft A, Smitz J. Intrafollicular endocrine milieu after addition of hCG to recombinant FSH during controlled ovarian stimulation for in vitro fertilization. J Clin Endocrinol Metab. 2014 Feb;99(2):517-26. doi: 10.1210/jc.2013-1528. Epub 2013 Dec 2.
Results Reference
derived
PubMed Identifier
22791754
Citation
Thuesen LL, Loft A, Egeberg AN, Smitz J, Petersen JH, Andersen AN. A randomized controlled dose-response pilot study of addition of hCG to recombinant FSH during controlled ovarian stimulation for in vitro fertilization. Hum Reprod. 2012 Oct;27(10):3074-84. doi: 10.1093/humrep/des256. Epub 2012 Jul 12.
Results Reference
derived
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Supplementation With Human Chorionic Gonadotropin (hCG) During Controlled Ovarian Stimulation With Recombinant Follicle-stimulating Hormone (FSH) for In Vitro Fertilisation
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