RCT of Low-dose Clomiphene vs. High Dose Gonadotropin Protocol for IVF Poor Responders

NCT ID: NCT01577199

Last Updated: 2016-12-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE4

Study Classification

INTERVENTIONAL

Study Start Date

2012-04-30

Study Completion Date

2012-12-31

Brief Summary

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The purpose of this study is compare two commonly-used medication protocols ( low-dose clomiphene citrate and high dose gonadotropin protocols) for the treatment of patients with diminished ovarian reserve (decreased number of eggs remaining in the ovary) undergoing IVF. This research is being done because we do not know if these two medication protocols are equally likely to help a woman become pregnant.

Detailed Description

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The objective of this protocol is to prospectively evaluate whether a clomid-based, low dose gonadotropin protocol (225 IU) would be non-inferior in terms of mature oocyte yield (eggs that are ready to be fertilized) as compared to a high-dose protocol.

Patients meeting the criteria for poor ovarian response will be consented and randomized to either a stimulation protocol involving pretreatment with a 0.1mg estradiol patch in the luteal phase starting 10 days after the LH surge (the hormone released by the brain to cause ovulation to occur, which is detectable in urine) followed by oral clomiphene citrate 100mg on days 2-6 of the menstrual cycle and 225 international units of gonadotropins starting on day 5, or to the control group involving the same pretreatment with 0.1mg luteal estradiol patches starting 10 days after the LH surge, with high dose gonadotropins (600IU) alone, starting on day 2 of the cycle. After randomization, patients will undergo routine IVF procedures, monitoring, blood draws, cancellation criteria, oocyte retrieval, and embryo transfer as non-study participants.

Conditions

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Infertility

Keywords

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IVF poor responder low ovarian reserve ART ovarian stimulation IVF protocols

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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High dose gonadotropins

High dose gonadotropins protocol compared to Low-dose Clomiphene

Group Type ACTIVE_COMPARATOR

High dose gonadotropins

Intervention Type DRUG

Pretreatment with a 0.1mg estradiol patch in the luteal phase starting 10 days after the LH surge followed high dose gonadotropins (eg. Follistim. Menopur) 600IU starting on day 2 of the cycle

Low-dose Clomiphene

clomid-based, low dose gonadotropin protocol compared to High dose gonadotropins

Group Type EXPERIMENTAL

Low-dose Clomiphene

Intervention Type DRUG

Pretreatment with a 0.1mg estradiol patch in the luteal phase starting 10 days after the LH surge followed by clomiphene citrate 100mgon days 2-6 of the menstrual cycle with 225 international units of gonadotropins (eg Follistim , Menopur) starting on day 5

Interventions

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Low-dose Clomiphene

Pretreatment with a 0.1mg estradiol patch in the luteal phase starting 10 days after the LH surge followed by clomiphene citrate 100mgon days 2-6 of the menstrual cycle with 225 international units of gonadotropins (eg Follistim , Menopur) starting on day 5

Intervention Type DRUG

High dose gonadotropins

Pretreatment with a 0.1mg estradiol patch in the luteal phase starting 10 days after the LH surge followed high dose gonadotropins (eg. Follistim. Menopur) 600IU starting on day 2 of the cycle

Intervention Type DRUG

Other Intervention Names

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clomiphene citrate with low dose gonadotropins Gonal F or Follistim

Eligibility Criteria

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Inclusion Criteria

* Patients age 18-42 undergoing IVF
* AFC \<7 (see definition above) and AMH (see definition above) \<0.5 and/or prior poor IVF response

Exclusion Criteria

* BMI (body mass index) \>30
* PGD (preimplantation genetic diagnosis, in which embryos are biopsied to rule out chromosomal abnormalities)
* Age \>42
* Fragile X carriers (a condition associated with premature ovarian aging)
* TESE (Testicular sperm extraction)
* Asherman's syndrome (uterine scarring which can affect implantation and pregnancy)
* Untreated hydrosalpinx (accumulated fluid in the fallopian tube which may be toxic to embryos)
* \>6 prior attempted cycles
Minimum Eligible Age

18 Years

Maximum Eligible Age

42 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Weill Medical College of Cornell University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Owen Davis, MD

Role: PRINCIPAL_INVESTIGATOR

WCMC

Countries

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United States

Related Links

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http://www.IVF.org

Center for Reproductive Medicine

Other Identifiers

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1112012095

Identifier Type: -

Identifier Source: org_study_id