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A Study to Evaluate Safety and Efficacy of Recombinant Human Luteinizing Hormone (r-hLH) Compared With Urinary Human Chorionic Gonadotrophin (u-hCG) to Trigger Ovulation in Infertile Women

Primary Purpose

Infertility

Status
Completed
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
r-hFSH
r-hLH
u-hCG
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, Ovulation induction, Recombinant human Luteinizing Hormone (r-hLH), Urinary human Chorionic Gonadotrophin (u-hCG), Recombinant human Follicle Stimulating Hormone (Gonal-f®)

Eligibility Criteria

20 Years - 40 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Infertile woman wishing to conceive and justifying ovarian stimulation treatment with gonadotrophins for in vivo conception
  • Aged 20-40 years (inclusive)
  • Male partner with acceptable semen analysis for intra-uterine insemination, according to center's standard practice
  • Have the following hormone serum levels measured locally during early (Day 2-4) follicular phase (if menstruating) or at anytime (if not menstruating):

    • Follicle stimulating hormone (FSH) less than 12 international unit per liter (IU/L)
    • Prolactin (PRL) less than 800 milli international unit per liter (mIU/l)
    • Lutenizing hormone (LH), P4, Testosterone (T) and Dehydroepiandrosterone sulphate (DHEA-S) for documentation purposes
  • At least one patent tube, as assessed with hysterosalpingography (HSG), ultrasound (U/S) or laparoscopy performed within 3 years prior to beginning r-hFSH treatment
  • Uterine cavity without abnormalities which, in the Investigator's opinion, could impair embryo implantation or pregnancy evolution as assessed with HSG, hysteroscopy (HSC) or U/S performed within 3 years prior to beginning r-hFSH treatment
  • Body mass index (BMI) greater than or equal to 18 and less than or equal to 35 kilogram per square meter (kg/m^2)
  • Negative serum or urinary pregnancy test prior to beginning r-hFSH treatment
  • Be willing and able to comply with the protocol for the duration of the study
  • Have given written informed consent, prior to any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to their future medical care

Exclusion Criteria:

  • Any contraindication to being pregnant and/or carrying a pregnancy to term
  • Clinically significant systemic disease (screening for Human Immunodeficiency Virus (HIV) and Hepatitis B and C surface antigens had to be performed to confirm eligibility, unless data obtained within one year prior to beginning r-hFSH treatment was available)
  • Any medical condition which in the judgment of the Investigator's and sponsor may have interfered with the absorption, distribution, metabolism or excretion of the study drug
  • Persistent ovarian cyst with a mean diameter larger than 20 mm or ovarian endometrioma, as assessed with U/S performed prior to beginning r-hFSH treatment
  • Severe endometriosis (American Fertility Society Classification Stage III or IV)
  • World health organization (WHO) Group I anovulation
  • Pelvic inflammatory disease within 1 year prior to beginning r-hFSH treatment
  • Treatment with clomiphene citrate or gonadotrophins within 1 month prior to beginning r-hFSH treatment
  • Abnormal undiagnosed gynecological bleeding
  • Known allergy or hypersensitivity to human gonadotrophins preparations
  • Known or current substance abuse
  • Previous participation in this study or simultaneous participation in another clinical trial

Sites / Locations

  • Royal University Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Active Comparator

Arm Label

r-hLH (825 International Units [IU])

r-hLH (2750 IU)

r-hLH (5500 IU)

r-hLH (11000 IU)

r-hLH (22000 IU)

u-hCG (5000 IU)

Arm Description

Outcomes

Primary Outcome Measures

Ovulation rate
Ratio of ruptured follicles per follicle with diameter greater than or equal to (>=) 15 millimeter (mm)
Number of follicles with diameter greater than or equal to (>=) 11 millimeter (mm)
Ratio of ruptured follicles per follicle with diameter greater than or equal to (>=) 11 millimeter (mm)

Secondary Outcome Measures

Percentage of participants with mono-follicular ovulation
Number of participants with biochemical pregnancy
Serum estradiol (E2) levels
Serum androstenedione levels
Serum total renin levels
Serum vascular endothelial growth factor (VEGF) levels
Endometrial thickness
Number of participants with clinical pregnancy
Serum progesterone (P4) levels

Full Information

First Posted
November 23, 2012
Last Updated
February 3, 2014
Sponsor
Merck KGaA, Darmstadt, Germany
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1. Study Identification

Unique Protocol Identification Number
NCT01735422
Brief Title
A Study to Evaluate Safety and Efficacy of Recombinant Human Luteinizing Hormone (r-hLH) Compared With Urinary Human Chorionic Gonadotrophin (u-hCG) to Trigger Ovulation in Infertile Women
Official Title
A Phase II, Single Center, Open, Randomized, Parallel Group, Dose Finding Study to Assess the Safety and Efficacy of Recombinant Human Luteinizing Hormone (r-hLH), Compared With Urinary Human Chorionic Gonadotrophin (u-hCG), in Inducing Ovulation in Infertile Women Undergoing Stimulation of Follicular Development With Recombinant Human Follicle Stimulating Hormone (Gonal F®).
Study Type
Interventional

2. Study Status

Record Verification Date
February 2014
Overall Recruitment Status
Completed
Study Start Date
December 1999 (undefined)
Primary Completion Date
July 2001 (Actual)
Study Completion Date
July 2001 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a single center, open-label, randomized, parallel group, dose finding study to evaluate safety and efficacy of recombinant human luteinizing hormone (r-hLH, LHadi®), compared with urinary human chorionic gonadotrophin (u-hCG, Profasi®), both given subcutaneously, in inducing ovulation in infertile women undergoing stimulation of follicular growth with recombinant human follicle stimulating hormone (r-hFSH, Gonal-F®).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infertility
Keywords
Infertility, Ovulation induction, Recombinant human Luteinizing Hormone (r-hLH), Urinary human Chorionic Gonadotrophin (u-hCG), Recombinant human Follicle Stimulating Hormone (Gonal-f®)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
67 (Actual)

8. Arms, Groups, and Interventions

Arm Title
r-hLH (825 International Units [IU])
Arm Type
Experimental
Arm Title
r-hLH (2750 IU)
Arm Type
Experimental
Arm Title
r-hLH (5500 IU)
Arm Type
Experimental
Arm Title
r-hLH (11000 IU)
Arm Type
Experimental
Arm Title
r-hLH (22000 IU)
Arm Type
Experimental
Arm Title
u-hCG (5000 IU)
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
r-hFSH
Other Intervention Name(s)
Gonal-f®
Intervention Description
Daily r-hFSH treatment will be administered subcutaneously at a starting dose according to the site's standard practice from Day 3-5 of menstrual cycle up to follicular development or 28 days. Dose can be altered according to ovarian response (reduced to 75 IU/day; increased to 225 IU/day).
Intervention Type
Drug
Intervention Name(s)
r-hLH
Other Intervention Name(s)
LHadi®
Intervention Description
Ovulation triggering will be performed using a single injection of r-hLH injection subcutaneously at a dose of 825 or 2750 or 5500 or 11,000 or 22,000 IU as soon as follicles satisfy the criteria for follicular development, that is at least 1 follicle with diameter >= 18 mm, not more than 5 follicles with diameter >= 15 mm and with E2 levels less than 9000 picomoles per liter (pmol/L).
Intervention Type
Drug
Intervention Name(s)
u-hCG
Intervention Description
Ovulation triggering will be performed using a single injection of 5000 IU of u-hCG as soon as follicles satisfy the criteria for follicular development, that is at least 1 follicle with diameter >= 18 mm, not more than 5 follicles with diameter >= 15 mm and with E2 levels less than 9000 picomoles per liter (pmol/L).
Primary Outcome Measure Information:
Title
Ovulation rate
Time Frame
Day 4 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Ratio of ruptured follicles per follicle with diameter greater than or equal to (>=) 15 millimeter (mm)
Time Frame
Day 4 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Number of follicles with diameter greater than or equal to (>=) 11 millimeter (mm)
Time Frame
Day 4 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Ratio of ruptured follicles per follicle with diameter greater than or equal to (>=) 11 millimeter (mm)
Time Frame
Day 4 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Secondary Outcome Measure Information:
Title
Percentage of participants with mono-follicular ovulation
Time Frame
Day 4 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Number of participants with biochemical pregnancy
Time Frame
Day 25-30 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Serum estradiol (E2) levels
Time Frame
Day 1, 2 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Serum androstenedione levels
Time Frame
Day 1, 2 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Serum total renin levels
Time Frame
Day 1, 2 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Serum vascular endothelial growth factor (VEGF) levels
Time Frame
Day 1, 2 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Endometrial thickness
Time Frame
Day 0, 1, 2, 3, 4 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Number of participants with clinical pregnancy
Time Frame
Day 25-30 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])
Title
Serum progesterone (P4) levels
Time Frame
Day 1, 2 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days])

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Infertile woman wishing to conceive and justifying ovarian stimulation treatment with gonadotrophins for in vivo conception Aged 20-40 years (inclusive) Male partner with acceptable semen analysis for intra-uterine insemination, according to center's standard practice Have the following hormone serum levels measured locally during early (Day 2-4) follicular phase (if menstruating) or at anytime (if not menstruating): Follicle stimulating hormone (FSH) less than 12 international unit per liter (IU/L) Prolactin (PRL) less than 800 milli international unit per liter (mIU/l) Lutenizing hormone (LH), P4, Testosterone (T) and Dehydroepiandrosterone sulphate (DHEA-S) for documentation purposes At least one patent tube, as assessed with hysterosalpingography (HSG), ultrasound (U/S) or laparoscopy performed within 3 years prior to beginning r-hFSH treatment Uterine cavity without abnormalities which, in the Investigator's opinion, could impair embryo implantation or pregnancy evolution as assessed with HSG, hysteroscopy (HSC) or U/S performed within 3 years prior to beginning r-hFSH treatment Body mass index (BMI) greater than or equal to 18 and less than or equal to 35 kilogram per square meter (kg/m^2) Negative serum or urinary pregnancy test prior to beginning r-hFSH treatment Be willing and able to comply with the protocol for the duration of the study Have given written informed consent, prior to any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to their future medical care Exclusion Criteria: Any contraindication to being pregnant and/or carrying a pregnancy to term Clinically significant systemic disease (screening for Human Immunodeficiency Virus (HIV) and Hepatitis B and C surface antigens had to be performed to confirm eligibility, unless data obtained within one year prior to beginning r-hFSH treatment was available) Any medical condition which in the judgment of the Investigator's and sponsor may have interfered with the absorption, distribution, metabolism or excretion of the study drug Persistent ovarian cyst with a mean diameter larger than 20 mm or ovarian endometrioma, as assessed with U/S performed prior to beginning r-hFSH treatment Severe endometriosis (American Fertility Society Classification Stage III or IV) World health organization (WHO) Group I anovulation Pelvic inflammatory disease within 1 year prior to beginning r-hFSH treatment Treatment with clomiphene citrate or gonadotrophins within 1 month prior to beginning r-hFSH treatment Abnormal undiagnosed gynecological bleeding Known allergy or hypersensitivity to human gonadotrophins preparations Known or current substance abuse Previous participation in this study or simultaneous participation in another clinical trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Responsible
Organizational Affiliation
Merck Serono International SA
Official's Role
Study Director
Facility Information:
Facility Name
Royal University Hospital
City
Saskatoon
State/Province
Saskatchewan
Country
Canada

12. IPD Sharing Statement

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A Study to Evaluate Safety and Efficacy of Recombinant Human Luteinizing Hormone (r-hLH) Compared With Urinary Human Chorionic Gonadotrophin (u-hCG) to Trigger Ovulation in Infertile Women

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