IVF Clinical Trial
Official title:
Follicle Stimulating Hormone (FSH) Followed by Human Menopausal Gonadotropin (HMG) Versus FSH Plus HMG During Controlled Ovarian Stimulation for in Vitro Fertilization
The aim of this study is to compare the clinical outcomes of sequential administration of FSH and HP-hMG FSH alone versus concomitant administration of FSH and HP-hMG during controlled ovarian stimulation in IVF cycles.
Women who are planned to be subjected to IVF/ICSI through COS by long GnRHa protocol will be
assessed for possibility of participation in our study. Eligible participants in our study
will be those with regular menstrual cycle (21-35 days) and normal uterine anatomy (confirmed
by transvaginal ultrasound examination and in some cases hysteronsalpingography and
hysteroscopy).
Women with any of the following criteria will be excluded from the study: 1) age < 20 or > 37
years; 2) body mass index (BMI) < 18 or > 25 kg/m2; 3) low ovarian reserve (AFC < 7 and/or
AMH < 1.1 ng/ml); 4) presence of polycystic ovarian syndrome (PCOS), endometrioma or
hydrosalpinx; 5) history of chemotherapy, radiotherapy or ovarian surgery; 6) the husband
needs testicular biopsy to obtain sperm; or 7) previous implantation failure.
A written informed consent will be taken from each women selected to participate before
inclusion in the study. All women participating in the study will start GnRHa on day 21 of
the preceding cycle and when down regulation occurs each woman will be randomly allocated
into one of the two groups; group 1 and group 2. Women in group 1 will receive 225 IU FSH
alone from day one of ovarian stimulation and when the follicular diameters reaches 10-12 mm,
the 150 IU HP-hMG will substitute FSH and continued to the day of triggering. Women in group
2 will receive 150 IU FSH plus 75 IU HP-hMG from day one of ovarian stimulation and 150IU
HP-HMG when the follicular diameters reaches 10-12 mm till day of triggering. The
randomization will be simple and balanced (1:1) and will be carried out by a nurse through
sealed, unlabeled, opaque envelopes containing computer-generated random numbers. The data
assesor will be blinded to group assignment.
In both groups, estradiol and LH will be measured on the third day of menstruation before
start of stimulation and on day 6 of stimulation TVS will be performed. Progesterone and E2
will be measured and on day of triggering. The primary outcome measure of this study will be
the ongoing pregnancy rate. The secondary outcomes measures will be cancellation rate, the
number of oocytes retrieved, the number of embryos, the number of vitrified embryos, the
clinical pregnancy rate, the implantation rate, OHSS rate, multiple pregnancy rate, and the
miscarriage rate.
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