Infertility, Female Clinical Trial
Official title:
Ovarian Response to Controlled Ovarian Stimulation Measured Through the Follicular Output Rate (FORT)
Objective: To study whether an administration of corifollitropin alpha modifies the
follicular cohort, measured by Follicular Output Rate (FORT), compared to human menopausal
gonadotropin (HMG), in infertile patients undergoing in vitro fertilisation (IVF).
M/M: 306 infertile patients undergoing in vitro fertilisation (IVF). Ovarian stimulation
protocol will be performed with a single dose of 100 μg (<60kg) or 150 μg (≥60kg)
corifollitropin alpha in group 1 (n=147), and 150-300 IU/day human menopausal gonadotropin
(HMG) according to age, antimullerian hormone (AMH) level and antral follicle count (AFC) in
group 2 (n=150).
Moreover, FORT will be calculated as the ratio of pre-ovulatory follicle (16-22 mm in
diameter) count on day of HCG×100/small antral follicle (3-8 mm) count at baseline.
Patients will be allocated for convenience into two groups: those who would receive
corifollitropin alpha (Group 1) or HMG (Group 2).
Ovarian stimulation protocol will be performed with a single dose of 100 μg (<60 kg) or 150
μg (≥60 kg) of corifollitropin alpha (Elonva, Schering-Plough, Brazil) in group 1, which
could be followed by daily administration of HMG beginning on day 8 if necessary; in group 2
150-300 IU/day HMG (menotropin, Menopur, Ferring, Brazil) will be administered, starting on
cycle day 3, according to age, AMH level and AFC, plus gonadotropin-releasing hormone
antagonist co-treatment (Ganirelix 25 mcg/day, Orgalutran, Schering-Plough, Brazil) in a
flexible protocol (at least 1 follicle >14 mm or 3 or more follicles >12 mm). Doses will be
adjusted as needed by the patient according to the ultrasound, which is performed with a 6
MHz multifrequency transvaginal probe (Toshiba, Japan). The criterion for HCG administration
(5.000 IU Choriomon, Biopharma, Brazil) will be at least three follicles greater than 17 mm,
and then, 36 hours later, transvaginal oocyte retrieval was performed. After 3 or 5 days, one
or two good-quality embryos will be transferred. It will be performed intracytoplasmic sperm
injection (ICSI) instead of conventional IVF when major male factor is presented.
Primary outcome measure is FORT. Secondary outcome measures include number of oocytes
retrieved, MII, duration of stimulation, number of embryos, embryo quality and clinical
pregnancy rate. Adverse events, such as ovarian hyperstimulation syndrome (OHSS) or
drug-related complications are also monitored.
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