Infertility Clinical Trial
Official title:
Controlled Ovarian Stimulation With Letrozole Supplementation
This research is being done to determine whether the success rate of in vitro fertilization treatment can be improved, while lowering the cost incurred from infertility medications using a pill called letrozole.
Specific Aim:
1. To determine whether addition of letrozole to gonadotropins would reduce the amount of
gonadotropins used in an IVF-ET cycle, thereby reducing the cost.
2. To determine whether letrozole improves IVF-ET success compared to standard ovarian
stimulation protocols.
Null Hypothesis: Use of Letrozole for ovulation induction in IVF is not less expensive than
the standard therapy by a clinically relevant amount.
Alternative Hypothesis: Use of Letrozole for ovulation induction in IVF is better than the
standard therapy by a clinically relevant amount.
Protocol:
Infertile women <40 years of age with age-appropriate ovarian reserve (as determined by
day2/3 E2, FSH, and AMH) will be randomized between two protocols: one with letrozole and
one with standard ovulation induction.
In both groups, serum FSH will be measured each time a sample is obtained for estradiol.
Sera will be frozen for further batch assay.
Number of embryos to be transferred will be decided following the ASRM guidelines. The day
of embryo transfer (D-3 vs D-5) will be based on the number and quality of embryos as per
established clinical criteria.
Power Considerations
A review of 1473 cycles of patients less than 40 years old over the last 6 years (2002 -
2008) revealed average cost per cycle to be $3,152 +/- 1685(SD).
For the purpose of this power analysis we consider a 20% decrease in medication cost to be
clinically significant. Thus a decrease from $ 3152.83 to $ 2522.26 will be considered
clinically significant (20% decrease). For an alpha of 0.05 and a power of 80% for a two
tailed test 113 patients will need to complete each arm.
Allowing for 10% drop-out we will attempt to randomize 125 patients to each arm of the
study.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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