Infertility Clinical Trial
Official title:
A Randomised Trial to Compare Antral Follicle Count and Serum Anti-Mullerian Hormone Level for Determination of Gonadotrophin Dosing in In-vitro Fertilisation
This is a prospective randomized trial to compare the use of AFC and serum AMH as the basis
for gonadotrophin dosing in in-vitro fertilization treatment.
The hypothesis is that the use of serum AMH as the criterion for determination of
gonadotrophin dosing in IVF treatment results in more optimal ovarian response than AFC.
Patients undergoing the first-time IVF treatment cycle using either conventional insemination
technique or intracytoplasmic sperm injection at Queen Mary Hospital will be invited to
participate in this study. Participating subjects will be randomized into either (i) AFC or
(ii) AMH group, where the gonadotrophin dosing will be determined based on the baseline AFC
and serum AMH respectively as assessed one month before the IVF treatment. Randomisation will
be performed according to a computer-generated list which will be read by an independent
research nurse. That research nurse will assign the initial gonadotrophin dose according to
the study protocol.
In the AFC group, starting dose of gonadotrophin will be determined based on serum AMH
concentration as follows:
AFC <= 5: 300 IU daily AFC >5 and <=15: 225 IU daily AFC >15: 150 IU daily
In the AMH group, starting dose of gonadotrophin will be determined based on serum AMH
concentration as follows:
AMH <= 1.0 ng/ml: 300 IU daily AMH >1.0 and <=3.3 ng/ml: 225 IU daily AMH >3.3 ng/ml: 150 IU
daily
The clinician and patient will both be blinded to the randomization throughout the course of
treatment. The proportion of subjects having appropriate ovarian response, defined as the
number of oocytes retrieved being 6 to 14 inclusive, will be compared between the two arms.
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