Infertility Clinical Trial
Official title:
A Randomized Controlled Trial to Compare the Efficacy Between Pergoveris and Follitropin Alfa in Ovarian Stimulation in Patients Aged ≥ 35 Years
To compare the efficacy between LH supplementation (Pergoveris) and non-LH supplementation
(Follitropin alpha) in patients aged ≥ 35 years undergoing IVF treatment.
Study hypothesis: Pergoveris (LH supplementation) is better than follitropin alpha (non-LH
supplementation) for ovarian stimulation in aged IVF patients.
A randomized controlled single center study.
Based on the difference of 19.1% in the clinical pregnancy rate between the two treatment
groups, with and without LH supplementation, in a previous study, with 90% power and a
2-sided P-value of 0.05, the number of subjects required was 109 per group (total 218). The
recruitment target was 120 subjects per group (total 240) to allow for dropouts.
Eligible subjects were randomized in blocks of 4 via a computer generated random number list
to either the Pergoveris arm or the follitropin alpha arm.
Ovarian stimulation was performed by using GnRH antagonist protocol.
Follitropin alfa (recombinant FSH) was administered on day 2 or day 3 of the menstrual
cycle. The first FSH dose was determined according to each individual patient, based on the
process as follows:
- AFC ≤ 6: 300 IU/day
- AFC 7-15: 225 IU/day
- AFC ≥ 16: 150 IU/day
GnRH antagonist (Cetrotide, Merck-Serono) was administered on day 5 of FSH administration.
- Recombinant LH (in the form of Pergoveris) was supplemented from day 6 of FSH
administration. Patients in the Pergoveris group would be administered a reduced dose
of recombinant FSH (reduced by 150 IU/day) which was replaced with Pergoveris (150IU
FSH + 75IU LH)/day.
- The Follitropin alpha group retained recombinant FSH. In both groups, if the number of
developing follicles was inappropriate, the dose could be titrated depending on the
physician's judgment.
Monitoring the follicular development was performed by vaginal ultrasound probe, quantifying
LH, estradiol and progesterone, starting from day 5 of FSH, based on the current processes
of the hospital.
OPU and embryo transfer: OPU was performed 36 hours after hCG administration. Embryos were
transferred on day 2.
Luteal phase support: daily vaginal progesterone
Pregnancy testing and ultrasound: a pregnancy test was done 14 days after embryo transfer.
Beta hCG > 5mIU/ml was considered positive. Fetal ultrasound was performed 3 weeks after a
positive pregnancy test to verify clinical pregnancy.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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