Infertility Clinical Trial
Official title:
Reducing the Impact of Ovarian Stimulation - The RIOT Project Study RIOT-B: Mapping the Endocrine Determinants of Ovarian Stimulation to Optimize Outcomes in Fresh Embryo Transfer Cycles
The goal of this project is to identify autocrine, paracrine and endocrine factors which are
associated with intercycle variation in cyclical follicle recruitment.
Patients will be monitored in a natural cycle, a stimulated cycle and a follow up. In the
stimulated cycle patients will be randomized to co-treatment with aromatase inhibitor or
placebo during ovarian stimulation.
The primary aim of this project is to explore the putative cyclic recruitment 'gatekeeping'
functions of gonadotropins, sex steroids, anti-muellarian hormone and pregnancy associated
plasma protein A in normal ovulatory cycles, and the impact of ovarian stimulation on cyclic
follicle recruitment in the following cycle.
It is further proposed that supra-physiological levels of estradiol and progesterone which
arise from ovarian stimulation may modulate the size of the secondarily recruited follicle
cohort in the next cycle. In order to explore the relative contribution of sex steroids as
determinants of the size of the next cycle 'wave' of recruitment further, a second aim of
this study will be investigate whether limiting the rise in sex steroid levels during ovarian
stimulation, by co-treatment with aromatase inhibitor impacts on cyclic recruitment.
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