To investigate the efficacy and safety of a single injection of 150 μg Corifollitropin Alfa (Organon 36286) to induce multifollicular development for controlled ovarian stimulation using daily recombinant FSH (recFSH) as a reference. The primary hypothesis is that a single injection of Corifollitropin Alfa is non-inferior to daily treatment with recFSH in initiating multifollicular growth.
This is a randomized, double-blind, active-controlled, non-inferiority clinical trial investigating the efficacy and safety of a new treatment regimen with Corifollitropin Alfa, a recombinant gonadotropin applied to initiate and sustain follicular stimulation in controlled ovarian stimulation for Assisted Reproductive Technology (ART). For this regimen, participants receive a single injection of Corifollitropin Alfa and one week later, treatment is continued with daily recFSH up to the day of triggering final oocyte maturation. In the reference group participants receive daily injections of recFSH up to the day of triggering final oocyte maturation. Non-inferiority in ongoing pregnancy rates (assessed at least 10 weeks after embryo transfer) will be the primary endpoint for this trial. The number of oocytes retrieved will be analyzed as co-primary endpoint.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
1,509
On the morning of day 2 or 3 of the menstrual cycle (Stimulation Day 1), a single SC injection of 150 μg (0.5 mL) Corifollitropin Alfa was administered in the abdominal wall.
Daily SC injections with 200 IU fixed dose recFSH were started on Stimulation Day 1 and continued up to and including Stimulation Day 7.
Pre-filled syringe containing an identical solution when compared to Corifollitropin Alfa. On the morning of day 2 or 3 of the menstrual cycle (Stimulation Day 1), a single SC injection was administered in the abdominal wall.
Identical ready-for-use solution, but without the active ingedient, supplied in cartridges for SC injection with the Follistim Pen. Daily SC injections were started on Stimulation Day 1 and continued up to and including Stimulation Day 7.
From Stimulation Day 8 onwards a daily SC dose of 200 IU recFSH was administered up to and including the Day of hCG.
On Stimulation Day 5 a daily SC injection of 0.25 mg was started, which continued up to and including the day of hCG
When 3 follicles \>= 17 mm were observed by USS, a single dose of 10,000 IU/USP hCG was administered; or, for those at risk for Ovarian Hyperstimulation Syndrome (OHSS), a lower dose of 5,000 IU/USP
On the day of OPU, luteal phase support was started by administering micronized progesterone of at least 600 mg/day vaginally, or at least 50 mg/day intramuscular (IM), which continued for at least 6 weeks, or up to menses.
Percentage of Participants With an Ongoing Pregnancy (Ongoing Pregnancy Rate)
An ongoing pregnancy is a fetus with heart activity at least 10 weeks after embryo transfer as assessed by Ultrasound Scan (USS) or Doppler or is confirmed by live birth. The ongoing pregnancy rate is 100 times the number of participants with an ongoing pregnancy after embryo transfer, divided by the total number of participants who started treatment. Calculations were made per attempt, meaning that participants who did not have embryo transfers were considered not pregnant.
Time frame: Assessed at least 10 weeks after embryo transfer (up to 1 year)
Mean Number of Oocytes Retrieved
Up to 36 hours after receiving hCG, cumulus-oocyte-complexes were retrieved. Mean numbers retrieved were calculated per attempt, meaning that if a participant did not reach this stage in In Vitro Fertilization (IVF) treatment, zero values were imputed.
Time frame: Up to 36 hours after administration of hCG (up to 1 year)
Median Amount of Recombinant FSH Needed to Induce Multifollicular Development Starting at Day 1
The amount of recFSH administered for a participant to reach 3 follicles \>= 17 mm, starting from treatment Day 1 onwards.
Time frame: From Day 1 to day of hCG treatment (up to 1 year)
Median Amount of Recombinant FSH Needed to Induce Multifollicular Development Starting at Day 8
The amount of recFSH administered for a participant to reach 3 follicles \>= 17 mm, starting from treatment Day 8 onwards.
Time frame: From Day 8 to Day of hCG treatment (up to 1 year)
Serum FSH Levels During Stimulation
Mean serum FSH are presented over one Controlled Ovarian Stimulation (COS) cycle: from Day 1 (Pre-dose) up to the day of hCG treatment.
Time frame: Up to day of hCG treatment (up to 1 year)
Serum Luteinizing Hormone (LH) Levels During Stimulation
Mean serum LH levels are presented over one COS cycle: from Day 1 (Pre-dose) up to the day of hCG treatment.
Time frame: Up to day of hCG treatment (up to 1 year)
Serum Estradiol (E2) Levels During Stimulation
Mean serum E2 levels are presented over one COS cycle: from Day 1 (Pre-dose) up to the day of hCG treatment.
Time frame: Up to day of hCG treatment (up to 1 year)
Serum Progesterone (P) Levels During Stimulation
Mean serum P levels are presented over one COS cycle: from Day 1 (Pre-dose) up to day of hCG treatment
Time frame: Up to day of hCG treatment (up to 1 year)
Serum Inhibin-B Levels During Stimulation
Mean serum Inhibin-B levels are presented over one COS cycle: from Day 1 (Pre-dose) up to day of hCG treatment
Time frame: Up to day of hCG treatment (up to 1 year)
Number of Follicles Categorized by Size on Stimulation Day 1
Ovaries were assessed during stimulation by ultrasonographic investigation (USS), and the mean number of follicles are categorized by their size.
Time frame: On Day 1 of treatment (up to 1 year)
Number of Follicles Categorized by Size on Stimulation Day 5
Ovaries were assessed during stimulation by USS, and the mean number of follicles are categorized by their size.
Time frame: On Day 5 of treatment (up to 1 year)
Number of Follicles Categorized by Size on Stimulation Day 8
Ovaries were assessed during stimulation by USS, and the mean number of follicles are categorized by their size.
Time frame: On Day 8 of treatment (up to 1 year)
Number of Follicles Categorized by Size on the Day of hCG
Ovaries were assessed during stimulation by USS, and the mean number of follicles are categorized by their size.
Time frame: Day of HCG treatment (up to 1 year)
Number of Cumulus-oocyte-complexes
Prior to IVF the mean number of cumulus-oocyte-complexes used for IVF was assessed
Time frame: Up to 36 hours after administration of hCG (up to 1 year)
Number of Oocytes Assessed Prior to Intracytoplasmic Sperm Injection (ICSI)
The number of oocytes used for ICSI was assessed, and categorized based on their quality
Time frame: Up to 36 hours after administration of hCG (up to 1 year)
Percentage of Fertilized Oocytes (Fertilization Rate)
The fertilization rate is 100 times the number of fertilized 2 pro-nuclei (2PN) oocytes obtained, divided by the number of oocytes fertilized by IVF or ICSI
Time frame: Up to 18 hours after start of fertilization (up to 1 year)
Number of Embryos Obtained on Day 3 Categorized by Quality
Embryos obtained on Day 3 were categorized by their qualiity as follows: Grade 1: excellent: No fragmentation, 6-10 cells, and equal blastomere size taking the impact of cell division into account. Grade 2: good: \< 20% fragmentation, 6-10 cells, and equal blastomere size taking the impact of cell division into account. Grade 3: fair: 20-50% fragmentation and/or less than 6 cells and/or multinucleation (if observed). Other Grade: Embryos that do not qualify as Grades 1, 2 or 3. Grades 1 and 2 are considered good quality.
Time frame: Post fertilization Day 3 (up to 1 year)
Number of Embryos Transferred on Day 3
After fertilization, the mean number of embryos transferred on Day 3 were assessed. Total and good quality embryos are presented, with good quality embryos, Grades 1 and 2, defined as the following: Grade 1: excellent: No fragmentation, 6-10 cells, and equal blastomere size taking the impact of cell division into account. Grade 2: good: \< 20% fragmentation, 6-10 cells, and equal blastomere size taking the impact of cell division into account.
Time frame: Post fertilization Day 3 (up to 1 year)
Percentage of Gestational Sacs (Implantation Rate)
The implantation rate is 100 times the number of gestational sacs assessed by USS after embryo transfer, divided by the number of embryos transferred.
Time frame: Up to 6 weeks after embryo transfer (up to 1 year)
Percentage of Participants With a Miscarriage (Miscarriage Rate) Per Clinical Pregnancy
The miscarriage rate is 100 times the number of miscarriages, divided by the number of clinical pregnancies assessed by USS. A clinical pregnancy is the presence of at least one gestational sac or confirmed by live birth.
Time frame: Up to day of miscarriage (up to 1 year)
Percentage of Participants With a Miscarriage (Miscarriage Rate) Per Vital Pregnancy
The miscarriage rate is 100 times the number of miscarriages, divided by the number of vital pregnancies assessed by USS. A vital pregnancy is the presence of at least one fetus with heart activity.
Time frame: Up to day of miscarriage (up to 1 year)
Percentage of Participants With a Biochemical Pregnancy (Pregnancy Rate) Per Attempt
Biochemical pregnancy was assessed by measuring serum or urinary hCG. Per attempt means that if a participant did not reach the stage of pregnancy assessment zero values were imputed. The pregnancy rate is 100 times the number of participants with pregnancies detected, divided by the number of participants assessed.
Time frame: Two weeks after embryo transfer (up to 1 year)
Percentage of Participants With a Biochemical Pregnancy (Pregnancy Rate) Per Embryo Transfer
Biochemical pregnancy was assessed for participants who had embryo transfer by measuring serum or urinary hCG. The pregnancy rate is 100 times the number of participants with pregnancies detected, divided by the number of participants assessed.
Time frame: Two weeks after embryo transfer (up to 1 year)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.