Subfertility Clinical Trial
Official title:
A Randomized Controlled Comparison of Human Chorionic Gonadotrophin as Luteal Phase Support in Frozen-thawed Embryo Transfer Cycles
A randomised trial on the use of luteal phase support in frozen-thawed embryo transfer
cycles.
The hypothesis of the study is that the use of luteal phase support with human chorionic
gonadotrophin would increase the pregnancy rate in frozen-thawed embryo transfer cycles.
Trial design:
-A total of 450 women undergoing FET in the Centre of Assisted Reproduction and Embryology,
The University of Hong Kong-Queen Mary Hospital, will be recruited. They will be randomized
into one of the following two groups by computer-generated random numbers:
Group I: luteal phase support using HCG 1500 IU intramuscular injection will be given on the
day of FET and 6 days later.
Group II: normal saline (placebo) intramuscular injection will be given on the day of FET
and 6 days later.
Treatment:
Ovarian stimulation protocol:
All women received ovarian stimulation according to the standard protocol of the Centre. HCG
is given intramuscularly when the leading follicle reaches 18 mm in mean diameter. Oocyte
retrieval is carried out 36 hours after the HCG trigger. A maximum of two embryos will
transferred and any excess good quality embryos will be frozen two days after the retrieval.
FET cycle:
FET is carried out at least 2 month after the stimulated cycle if the patient fails to get
pregnant in the stimulated IVF cycle and there is at least one frozen embryo. Frozen embryos
after thawing are transferred in natural cycles for those women having regular ovulatory
cycles, during which the patient is monitored daily for serum estradiol ad luteinising
hormone levels from 18 days before the expected date of the next period.
The transfer is performed by the team clinician on the third day after the luteinising
hormone surge and a maximum of two normally cleaving embryos are replaced according to our
standard protocol. The luteal phase is supported as per randomization arm. Before the embryo
transfer, the patient is interviewed by a designated research nurse who will explain the
purpose of this study. Patients consenting to take part in the study will be assigned into
one of the two study arms specified in an opaque envelope according to a computer-generated
randomization list. The envelope will be read and injection (HCG or placebo as normal
saline) given by a service nurse not involved in the study. Blood will be taken on day 6
after FET before the patient receives the second dose of HCG or placebo. A urine pregnancy
test will be performed 16 days after the FET. In case of pregnancy, the outcome of pregnancy
will be traced afterwards and used for analysis. Luteal phase support is not continued in
those who get pregnant.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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