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Comparison of MENOPUR Liquid and Powder in Women Undergoing Assisted Reproductive Technology (ART) (CLARA)

Primary Purpose

Infertility

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
MENOPUR solution for injection in pre-filled pen, 1200 IU/1.92 mL
MENOPUR powder and solvent for solution for injection, 75 IU
Placebo (for MENOPUR solution for injection in pre-filled pen)
Placebo (for MENOPUR powder and solvent for solution for injection)
Sponsored by
Ferring Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Infertility focused on measuring Controlled Ovarian Stimulation, Assisted Reproductive Technology

Eligibility Criteria

18 Years - 42 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Signed informed consents, prior to any trial-related procedure.
  • Females between the ages of 18 and 42 years. The participants must be at least 18 years (including the 18th birthday) when they sign the informed consent and no more than 42 years (up to the day before the 43rd birthday) at the time of randomization who desire pregnancy.
  • Body mass index (BMI) between 17.5 and 38.0 kg/m^2 (both inclusive) at screening.
  • Regular menstrual cycles of 24 to 35 days, presumed to be ovulatory.
  • Documented history of infertility for at least 12 months before randomization for women ≤35 years or for at least 6 months for women ≥36 years. Women with documented bilateral tubal occlusion or male factor infertility requiring the use of donor sperm established as a cause of infertility are eligible at diagnosis.
  • Early follicular phase (cycle day 2-4) serum FSH level between 1 and 12 IU/L (results obtained within 3 months prior to randomization).
  • Male partner with semen analysis that is at least adequate for intracytoplasmic sperm injection (ICSI) at screening or within 6 months prior to the screening date. Partners with severe male factors requiring invasive or surgical sperm retrieval may not be used. Use of donor sperm is allowed.
  • At least 1 cycle with no fertility medication immediately prior to screening.
  • Hysterosalpingography, hysteroscopy, or saline hysterosonogram documenting uterine anatomy appropriate for ART at screening or within 12 months prior to screening.
  • Transvaginal ultrasound documenting presence and adequate visualization of both ovaries, without evidence of clinically significant abnormality (e.g., endometrioma ≥3 cm, no dermoid cysts) and normal adnexa (e.g., no hydrosalpinx) at screening. Both ovaries must be accessible for oocyte retrieval.

Exclusion Criteria:

  • More than two previous controlled ovarian stimulation cycles for in vitro fertilization (IVF)/ICSI
  • Known stage III-IV endometriosis (American Society for Reproductive Medicine, 2012).
  • Oocyte donor or embryo recipient; gestational or surrogate carrier.
  • Known history of recurrent miscarriage (defined as three consecutive losses after ultrasound confirmation of pregnancy [excluding ectopic pregnancy] and before week 24 of pregnancy).
  • Participant's male partner, with obvious leukospermia (>2 million white blood cells/mL) or signs of infection in semen sample within 6 months of the participant's screening. If either of these conditions exists, the male should be treated with antibiotics and retested prior to the participant's randomization.
  • Active arterial or venous thromboembolism or severe thrombophlebitis, or a history of these events.
  • Any known endocrine (total testosterone, prolactin and TSH) or metabolic abnormalities (pituitary, adrenal, pancreas, liver or kidney) with the exception of controlled thyroid function disease.
  • Known tumors of the ovary, breast, uterus, adrenal gland, pituitary or hypothalamus which would contraindicate the use of gonadotrophins.
  • Any abnormal finding of clinical chemistry, hematology and vital signs at screening, which is judged clinically significant by the investigator.
  • Pregnancy (negative urine pregnancy test must be documented at screening and prior to the first investigational medicinal product [IMP] administration), or contraindication to pregnancy.
  • Hypersensitivity to any active ingredient or excipients in the medicinal products used in this trial.

Sites / Locations

  • Fertility Treatment Center
  • Fertility Specialists Medical Group - San Diego Center for Reproductive Surgery
  • Center for Advanced Reproductive Services PC
  • Yale Fertility Center
  • Fertility and IVF Center of Miami
  • Center for Reproductive Medicine
  • Idaho Center for Reproductive Medicine
  • Fertility Centers of Illinois
  • InVia Fertility Specialists, SC
  • Fertility Answers, LLC
  • SIRM Fertility Center
  • Reproductive Endocrinology Associates of Charlotte
  • Carolina Conceptions
  • Institute for Reproductive Health
  • OU Physicians Reproductive Medicine
  • Abington Reproductive Medicine
  • Fertility Associates of Memphis, PLLC
  • Center for Assisted Reproduction
  • Houston Fertility Institute
  • Center of Reproductive Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

MENOPUR liquid

MENOPUR powder

Arm Description

MENOPUR liquid (including placebo to MENOPUR powder) initiated at a fixed dose of 225 international units (IU) for first five stimulation days. From stimulation Day 6, dosing can be adjusted as needed every second day by 75 IU per adjustment based on the participant's follicular response. The maximum dose will be 450 IU/day and the minimum dose will be 75 IU/day. The dosing can continue for a maximum of 20 days.

MENOPUR powder (including placebo to MENOPUR liquid) initiated at a fixed dose of 225 IU for first five stimulation days. From stimulation Day 6, dosing can be adjusted as needed every second day by 75 IU per adjustment based on the participant's follicular response. The maximum dose will be 450 IU/day and the minimum dose will be 75 IU/day. The dosing can continue for a maximum of 20 days.

Outcomes

Primary Outcome Measures

Number of fertilized (2 pronuclei [2PN]) oocytes
Fertilized oocytes with 2PN will be regarded as correctly fertilized.

Secondary Outcome Measures

Positive beta human chorionic gonadotropin (βhCG) rate
Clinical pregnancy rate
Clinical pregnancy will be based on detection of at least 1 intrauterine gestational sac with fetal heart beat on transvaginal ultrasound.
Ongoing pregnancy rate
Ongoing pregnancy will be based on detection of at least 1 intrauterine viable fetus by transvaginal or abdominal ultrasound
Early pregnancy loss
Number of participants with early pregnancy loss defined as a positive βhCG tests but no ongoing pregnancy.
Follicular development on stimulation day 6
The total number of follicles and the number of follicles per size category will be reported.
Follicular development on last day of stimulation
The total number of follicles and the number of follicles per size category will be reported.
Serum follicle-stimulating hormone (FSH) concentration
Serum Anti-Müllerian hormone (AMH) concentration
Human chorionic gonadotropin concentration
Luteinizing hormone (LH) concentration
Progesterone (P4) concentration
Estradiol (E2) concentration
Number of oocytes retrieved
Number of metaphase II oocytes
Fertilization rate
Fertilization rate is the number of 2PN oocytes divided by the number of oocytes retrieved.
Number of blastocysts 5 days after oocyte retrieval
The number of blastocysts (total and good-quality) will be reported. Blastocyst quality is assessed by blastocyst expansion and hatching status, blastocyst inner cell mass grading, and trophectoderm grading. The scoring is based on the classification system by Gardner and Schoolcraft, with additional categories for inner cell mass (degenerative or no inner cell mass) and trophectoderm (degenerative or very large cells)
Total gonadotropin dose
Number of stimulation days
Proportion of participants with ovarian hyperstimulation syndrome (OHSS)
Frequency and intensity of adverse events
Changes in circulating levels of clinical chemistry parameters compared to baseline
Changes in circulating levels of haematology parameters compared to baseline
Frequency and intensity of injection site reactions (redness, pain, itching, swelling and bruising) assessed by the participant during the stimulation period
Proportion of participants with treatment-induced anti-MENOPUR antibodies
Technical malfunctions of the administration pen
Number of administration pens with technical malfunctions

Full Information

First Posted
October 28, 2019
Last Updated
May 18, 2022
Sponsor
Ferring Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04163458
Brief Title
Comparison of MENOPUR Liquid and Powder in Women Undergoing Assisted Reproductive Technology (ART)
Acronym
CLARA
Official Title
A Randomized, Double-blind Double-dummy Trial Comparing MENOPUR Solution for Injection in a Pre-filled Pen and MENOPUR Powder and Solvent for Solution for Injection (Menotropins for Injection) in a GnRH Agonist Cycle in Women Aged 18-42 Years Undergoing an Assisted Reproductive Technology Program
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
October 25, 2019 (Actual)
Primary Completion Date
May 24, 2021 (Actual)
Study Completion Date
July 16, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ferring Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Development of multiple follicles and pregnancy in ovulatory women undergoing controlled ovarian stimulation as part of an assisted reproductive technology (ART) cycle.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infertility
Keywords
Controlled Ovarian Stimulation, Assisted Reproductive Technology

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
413 (Actual)

8. Arms, Groups, and Interventions

Arm Title
MENOPUR liquid
Arm Type
Experimental
Arm Description
MENOPUR liquid (including placebo to MENOPUR powder) initiated at a fixed dose of 225 international units (IU) for first five stimulation days. From stimulation Day 6, dosing can be adjusted as needed every second day by 75 IU per adjustment based on the participant's follicular response. The maximum dose will be 450 IU/day and the minimum dose will be 75 IU/day. The dosing can continue for a maximum of 20 days.
Arm Title
MENOPUR powder
Arm Type
Active Comparator
Arm Description
MENOPUR powder (including placebo to MENOPUR liquid) initiated at a fixed dose of 225 IU for first five stimulation days. From stimulation Day 6, dosing can be adjusted as needed every second day by 75 IU per adjustment based on the participant's follicular response. The maximum dose will be 450 IU/day and the minimum dose will be 75 IU/day. The dosing can continue for a maximum of 20 days.
Intervention Type
Drug
Intervention Name(s)
MENOPUR solution for injection in pre-filled pen, 1200 IU/1.92 mL
Other Intervention Name(s)
Highly purified menotropin
Intervention Description
Solution for injection in pre-filled pen, subcutaneous administration
Intervention Type
Drug
Intervention Name(s)
MENOPUR powder and solvent for solution for injection, 75 IU
Other Intervention Name(s)
Highly purified menotropin
Intervention Description
Solution for injection in vials (powder and diluent), subcutaneous administration
Intervention Type
Other
Intervention Name(s)
Placebo (for MENOPUR solution for injection in pre-filled pen)
Intervention Description
Solution for injection in pre-filled pen, subcutaneous administration
Intervention Type
Other
Intervention Name(s)
Placebo (for MENOPUR powder and solvent for solution for injection)
Intervention Description
Solution for injection in vials (powder and diluent); subcutaneous administration
Primary Outcome Measure Information:
Title
Number of fertilized (2 pronuclei [2PN]) oocytes
Description
Fertilized oocytes with 2PN will be regarded as correctly fertilized.
Time Frame
On Day 1 after oocyte retrieval (up to 23 days after start of stimulation)
Secondary Outcome Measure Information:
Title
Positive beta human chorionic gonadotropin (βhCG) rate
Time Frame
10-14 days after transfer (up to approximately 6 weeks after start of stimulation)
Title
Clinical pregnancy rate
Description
Clinical pregnancy will be based on detection of at least 1 intrauterine gestational sac with fetal heart beat on transvaginal ultrasound.
Time Frame
5-6 weeks after transfer (up to approximately 10 weeks after start of stimulation)
Title
Ongoing pregnancy rate
Description
Ongoing pregnancy will be based on detection of at least 1 intrauterine viable fetus by transvaginal or abdominal ultrasound
Time Frame
8-9 weeks after transfer (up to approximately 13 weeks after start of stimulation)
Title
Early pregnancy loss
Description
Number of participants with early pregnancy loss defined as a positive βhCG tests but no ongoing pregnancy.
Time Frame
8-9 weeks after transfer (up to approximately 13 weeks after start of stimulation)
Title
Follicular development on stimulation day 6
Description
The total number of follicles and the number of follicles per size category will be reported.
Time Frame
At stimulation Day 6
Title
Follicular development on last day of stimulation
Description
The total number of follicles and the number of follicles per size category will be reported.
Time Frame
At last day of stimulation (up to 20 stimulation days)
Title
Serum follicle-stimulating hormone (FSH) concentration
Time Frame
At stimulation Day 1, 6, last day of stimulation (up to 20 stimulation days) and at oocyte retrieval (up to 22 days after start of stimulation)
Title
Serum Anti-Müllerian hormone (AMH) concentration
Time Frame
At stimulation Day 1, last day of stimulation (up to 20 stimulation days) and at end-of-trial (up to approximately 6.5 months from the start of screening)
Title
Human chorionic gonadotropin concentration
Time Frame
At stimulation Day 1, 6 and last day of stimulation (up to 20 stimulation days)
Title
Luteinizing hormone (LH) concentration
Time Frame
At stimulation Day 1, 6 and last day of stimulation (up to 20 stimulation days)
Title
Progesterone (P4) concentration
Time Frame
At stimulation Day 1, 6 and last day of stimulation (up to 20 stimulation days)
Title
Estradiol (E2) concentration
Time Frame
At confirmation of down-regulation (up to <90 days before stimulation Day 1), stimulation Day 6 and last day of stimulation (up to 20 stimulation days)
Title
Number of oocytes retrieved
Time Frame
On day of oocyte retrieval (up to 22 days after start of stimulation)
Title
Number of metaphase II oocytes
Time Frame
On day of oocyte retrieval (up to 22 days after start of stimulation)
Title
Fertilization rate
Description
Fertilization rate is the number of 2PN oocytes divided by the number of oocytes retrieved.
Time Frame
On Day 1 after oocyte retrieval (up to 23 days after start of stimulation)
Title
Number of blastocysts 5 days after oocyte retrieval
Description
The number of blastocysts (total and good-quality) will be reported. Blastocyst quality is assessed by blastocyst expansion and hatching status, blastocyst inner cell mass grading, and trophectoderm grading. The scoring is based on the classification system by Gardner and Schoolcraft, with additional categories for inner cell mass (degenerative or no inner cell mass) and trophectoderm (degenerative or very large cells)
Time Frame
On Day 5 after oocyte retrieval (up to 27 days after start of stimulation)
Title
Total gonadotropin dose
Time Frame
Up to 20 stimulation days
Title
Number of stimulation days
Time Frame
Up to 20 stimulation days
Title
Proportion of participants with ovarian hyperstimulation syndrome (OHSS)
Time Frame
≤9 days after triggering of final follicular maturation (early OHSS), >9 days after triggering of final follicular maturation (late OHSS)
Title
Frequency and intensity of adverse events
Time Frame
From the start of screening until the end-of-trial (up to approximately 6.5 months)
Title
Changes in circulating levels of clinical chemistry parameters compared to baseline
Time Frame
From the start of screening until the end-of-trial (up to approximately 6.5 months)
Title
Changes in circulating levels of haematology parameters compared to baseline
Time Frame
From the start of screening until the end-of-trial (up to approximately 6.5 months)
Title
Frequency and intensity of injection site reactions (redness, pain, itching, swelling and bruising) assessed by the participant during the stimulation period
Time Frame
Up to 20 stimulation days
Title
Proportion of participants with treatment-induced anti-MENOPUR antibodies
Time Frame
Up to 28 days after end of the stimulation period
Title
Technical malfunctions of the administration pen
Description
Number of administration pens with technical malfunctions
Time Frame
Up to 20 stimulation days

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
42 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consents, prior to any trial-related procedure. Females between the ages of 18 and 42 years. The participants must be at least 18 years (including the 18th birthday) when they sign the informed consent and no more than 42 years (up to the day before the 43rd birthday) at the time of randomization who desire pregnancy. Body mass index (BMI) between 17.5 and 38.0 kg/m^2 (both inclusive) at screening. Regular menstrual cycles of 24 to 35 days, presumed to be ovulatory. Documented history of infertility for at least 12 months before randomization for women ≤35 years or for at least 6 months for women ≥36 years. Women with documented bilateral tubal occlusion or male factor infertility requiring the use of donor sperm established as a cause of infertility are eligible at diagnosis. Early follicular phase (cycle day 2-4) serum FSH level between 1 and 12 IU/L (results obtained within 3 months prior to randomization). Male partner with semen analysis that is at least adequate for intracytoplasmic sperm injection (ICSI) at screening or within 6 months prior to the screening date. Partners with severe male factors requiring invasive or surgical sperm retrieval may not be used. Use of donor sperm is allowed. At least 1 cycle with no fertility medication immediately prior to screening. Hysterosalpingography, hysteroscopy, or saline hysterosonogram documenting uterine anatomy appropriate for ART at screening or within 12 months prior to screening. Transvaginal ultrasound documenting presence and adequate visualization of both ovaries, without evidence of clinically significant abnormality (e.g., endometrioma ≥3 cm, no dermoid cysts) and normal adnexa (e.g., no hydrosalpinx) at screening. Both ovaries must be accessible for oocyte retrieval. Exclusion Criteria: More than two previous controlled ovarian stimulation cycles for in vitro fertilization (IVF)/ICSI Known stage III-IV endometriosis (American Society for Reproductive Medicine, 2012). Oocyte donor or embryo recipient; gestational or surrogate carrier. Known history of recurrent miscarriage (defined as three consecutive losses after ultrasound confirmation of pregnancy [excluding ectopic pregnancy] and before week 24 of pregnancy). Participant's male partner, with obvious leukospermia (>2 million white blood cells/mL) or signs of infection in semen sample within 6 months of the participant's screening. If either of these conditions exists, the male should be treated with antibiotics and retested prior to the participant's randomization. Active arterial or venous thromboembolism or severe thrombophlebitis, or a history of these events. Any known endocrine (total testosterone, prolactin and TSH) or metabolic abnormalities (pituitary, adrenal, pancreas, liver or kidney) with the exception of controlled thyroid function disease. Known tumors of the ovary, breast, uterus, adrenal gland, pituitary or hypothalamus which would contraindicate the use of gonadotrophins. Any abnormal finding of clinical chemistry, hematology and vital signs at screening, which is judged clinically significant by the investigator. Pregnancy (negative urine pregnancy test must be documented at screening and prior to the first investigational medicinal product [IMP] administration), or contraindication to pregnancy. Hypersensitivity to any active ingredient or excipients in the medicinal products used in this trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Global Clinical Compliance
Organizational Affiliation
Ferring Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Fertility Treatment Center
City
Tempe
State/Province
Arizona
ZIP/Postal Code
85284
Country
United States
Facility Name
Fertility Specialists Medical Group - San Diego Center for Reproductive Surgery
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Facility Name
Center for Advanced Reproductive Services PC
City
Farmington
State/Province
Connecticut
ZIP/Postal Code
06032
Country
United States
Facility Name
Yale Fertility Center
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06511
Country
United States
Facility Name
Fertility and IVF Center of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
Center for Reproductive Medicine
City
Winter Park
State/Province
Florida
ZIP/Postal Code
32789
Country
United States
Facility Name
Idaho Center for Reproductive Medicine
City
Boise
State/Province
Idaho
ZIP/Postal Code
83702
Country
United States
Facility Name
Fertility Centers of Illinois
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60610
Country
United States
Facility Name
InVia Fertility Specialists, SC
City
Hoffman Estates
State/Province
Illinois
ZIP/Postal Code
60169
Country
United States
Facility Name
Fertility Answers, LLC
City
Baton Rouge
State/Province
Louisiana
ZIP/Postal Code
70817
Country
United States
Facility Name
SIRM Fertility Center
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89118
Country
United States
Facility Name
Reproductive Endocrinology Associates of Charlotte
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28207
Country
United States
Facility Name
Carolina Conceptions
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
Institute for Reproductive Health
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45209
Country
United States
Facility Name
OU Physicians Reproductive Medicine
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
Abington Reproductive Medicine
City
Abington
State/Province
Pennsylvania
ZIP/Postal Code
19046
Country
United States
Facility Name
Fertility Associates of Memphis, PLLC
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38120
Country
United States
Facility Name
Center for Assisted Reproduction
City
Bedford
State/Province
Texas
ZIP/Postal Code
76022
Country
United States
Facility Name
Houston Fertility Institute
City
Houston
State/Province
Texas
ZIP/Postal Code
77063
Country
United States
Facility Name
Center of Reproductive Medicine
City
Webster
State/Province
Texas
ZIP/Postal Code
77598
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Comparison of MENOPUR Liquid and Powder in Women Undergoing Assisted Reproductive Technology (ART)

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