Effect of Colony Stimulating Factor on Poor Endometrial Development During IVF

NCT ID: NCT01202643

Last Updated: 2019-07-26

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 12 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2010-09-30
• Study Completion Date: 2013-02-28

Brief Summary

The purpose of this study is to investigate the effect of G-CSF on endometrial thickness in women who have failed reaching minimal endometrial thickness by standard treatments, to assess how many reach embryo transfer and what implantation and pregnancy rates are in comparison to control patients. The study will be conducted in women undergoing transfer of previously cryopreserved embryos or undergoing transfer of embryos from donor eggs.

Detailed Description

Objective: To investigate the effect of treatment with CSF : A placebo controlled double blinded crossover study.

Design: Crossover Randomized Control Trial

Setting: Academically affiliated private infertility centers

Subjects: Female IVF patients of all ages who are willing to be randomized to treatment and, in either IVF treatment, frozen embryo cycles (FET) or donor IVF cycles (D-IVF), 5 days before ET, have inadequate endometrial thickness.

Interventions: Subjects receive transvaginally, utilizing an insemination catheter, 2 slow intrauterine lavages with CSF-1 (Neupogen or generic, 300ug in 1 ml) 5 and 3 days, respectively, before embryo transfer and controls receive 1 ml of saline instead. Patients who do not become pregnant will after one month washout times continue treatment in the opposite study arm if they so choose and if they have remaining embryos.

Main Outcome Measures: Number of patients reaching embryo transfer with adequate endometrial thickness of at least 7mm.

Second Outcome Measures: Implantation and pregnancy rates..

Statistical and Power considerations: This is a Randomized Controlled Trial (RCT) with two study arms and panned crossover. Patients will be randomly assigned to Study group A or B according to a computer generated randomization table with 50:50 distributions. The study will test the null hypothesis that there is no difference in the transfer rates between the two groups. Transfer is only possible if the endometrial thickness reaches 7 mm or more. Order of treatment ab v ba will be added to the models as a separate factor and each phase will be analyzed as separate treatment strata.

The investigators are planning a study of independent cases and controls with 1 control per case. Prior data indicate that the transfer rate among controls is < 1%. If the true transfer rate for experimental subjects is 25%, the investigators will need to study 38 experimental subjects and 38 control subjects to be able to reject the null hypothesis that the transfer rates for experimental and control subjects are equal with probability (power) 0.8. The Type I error probability associated with this test of this null hypothesis is 0.05. We will use a continuity-corrected chi-squared statistic or Fisher's exact test to evaluate this null hypothesis.

There will be a planned interim analysis after 20 participants have completed the trial and if significant effects are observed the trial may be terminated at that time. The power to detect a difference in this interim analysis is only 42.6%.

Conditions

Infertility, Female

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: TREATMENT
• Blinding Strategy: QUADRUPLE

Study Groups

G-CSF

G-CSF 300 units administered by trans-cervical infusion one time on day of hCG trigger for Ovulation

Group Type: EXPERIMENTAL

G-CSF

Intervention Type: DRUG

One infusion of G-CSF 300 units administered by intrauterine infusion

Saline

Saline administered by trans-cervical infusion one time on day of hCG trigger for ovulation

Group Type: PLACEBO_COMPARATOR

Saline

Intervention Type: DRUG

One intrauterine saline infusions of 1 cc

Interventions

G-CSF

One infusion of G-CSF 300 units administered by intrauterine infusion

Intervention Type: DRUG

Saline

One intrauterine saline infusions of 1 cc

Intervention Type: DRUG

Other Intervention Names

NEUPOGEN (Filgrastim); Normal Saline (Salt water); 0.91% w/v of NaCl, about 300 mOsm/L

Eligibility Criteria

Inclusion Criteria

• Patient's preparing for invitro fertilization and embryo transfer with endometrial growth of less than 7 mm, unresponsive to standard treatment

Exclusion Criteria

• Sickle Cell disease
• Renal insufficiency
• Upper respiratory infection or Pneumonia
• Chronic Neutropenia
• Known Past or present malignancy

• Minimum Eligible Age: 21 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

Foundation for Reproductive Medicine

OTHER

Sponsor Role: collaborator

Center for Human Reproduction

OTHER

Sponsor Role: lead

Responsible Party

David H. Barad

Director of Clinical Research

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

David H Barad, MD, MS

Role: PRINCIPAL_INVESTIGATOR

Center for Human Reproduction

Norbert Gleicher, MD

Role: STUDY_CHAIR

Center for Human Reproduction

Locations

Center for Human Reproduction

New York, New York, United States

Countries

United States

Other Identifiers

09012010-01

Identifier Type: -

Identifier Source: org_study_id