Predicting Ovarian Response in Artificial Insemination With Low Stimulation

NCT ID: NCT01662180

Last Updated: 2012-12-13

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

UNKNOWN

Total Enrollment

510 participants

Study Classification

OBSERVATIONAL

Study Start Date

2012-12-31

Study Completion Date

2015-03-31

Brief Summary

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This large prospective multi-center cohort study aims to identify patient's characteristics that significantly influence ovarian response to mild stimulation with a fixed dose of 75 IU recombinant FSH.

Detailed Description

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A multi-center, open-label, prospective cohorts study. Patients with a regular indication for COH/IUI (controlled ovarian stimulation/ intra uterine insemination) will be asked to participate. Patient's characteristics will be documented including age, weight, BMI, smoking status, cycle day 2 3 or 4 FSH /Estradiol levels, antral follicle count, and AMH. AMH and FSH/Estradiol will be determined centrally after completion of inclusion of all patients in the study. All patients will receive a fixed 75 IU recFSH per day conform normal stimulation protocol starting from cycle day 3, 4 or 5 after exclusion of ovarian cysts by ultrasound. Ovarian response will be documented by ultrasound only. Once the dominant follicle(s) reach a mean diameter of 16-18 mm, hCG (5000IU or 250 mcg) will be applied and insemination will be scheduled 36-42 hours later. Cancellation criteria will be defined according to the national guidelines provided by the NVOG (7).

Conditions

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Subfertility

Keywords

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subfertility, IUI, rec FSH, FSH, E2, AMH

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Subfertile couples

Subfertile couples presenting at fertility clinics with an indication for IUI in stimulated cycles

All patients will receive a fixed 75 IU recombinant follicle stimulating hormone per day conform normal stimulation protocol starting from cycle day 3, 4 or 5. Once the dominant follicle(s) reach a mean diameter of 16-18 mm, hCG (5000IU or 250 mcg) will be applied and insemination will be scheduled 36-42 hours later. Patients will be followed for the time of one menstrual cycle.

Follicle Stimulating Hormone

Intervention Type DRUG

All patients will receive a fixed 75 IU rec follicle stimulating hormone per day subcutaneous injection stimulation protocol starting from cycle day 3, 4 or 5. The intervention done in this study is conform normal stimulation protocol and is not the target of this study.

Interventions

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Follicle Stimulating Hormone

All patients will receive a fixed 75 IU rec follicle stimulating hormone per day subcutaneous injection stimulation protocol starting from cycle day 3, 4 or 5. The intervention done in this study is conform normal stimulation protocol and is not the target of this study.

Intervention Type DRUG

Other Intervention Names

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Puregon [Merck Sharp & Dohme bv] Gonal -F [Serono Benelux bv]

Eligibility Criteria

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Inclusion Criteria

* couples with unexplained or mild male subfertility (1-3) and a spontaneous chance of conception below 40% (Hunault score).
* Unexplained subfertility including minimal to mild endometriosis (AFS grade 1 or 2) is defined as the failure to conceive after at least one year of unprotected intercourse whereas the standard fertility work-up was unable to detect any factors that might influence fertility negatively.
* semen analysis should be normal according to the WHO guidelines (8),
* ovulation should be documented (by BBT charts, ovulation detection by ultrasound or normal luteal progesterone values),
* tubal patency should be confirmed (HSG, laparoscopy or fertiloscopy) and when a postcoital test was performed a cervical factor should have been excluded.
* Mild male subfertility is defined as abnormal semen parameters according to the WHO (8) but an average total motile sperm account before processing of at least 10 million.

Exclusion Criteria

* Hunault score ≥ 40%
* Endometriosis AFS grade 3 or 4
* Contra-indications for the use of gonadotrophins (cysts larger than 2 cm, allergy for gonadotrophins)
* Total motile sperm count after sperm processing below 1 million
* Women aged younger than eighteen years or older than 45 years.
* Previous treatment with COH/IUI for treating current subfertility
* Unable to speak or read the Dutch language
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Merck Serono International SA

INDUSTRY

Sponsor Role collaborator

Isala

OTHER

Sponsor Role lead

Responsible Party

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M. Bloemendal

drs.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ben Cohlen, dr.

Role: PRINCIPAL_INVESTIGATOR

Isala

Locations

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OLVG

Amsterdam, Po 95500, Netherlands

Site Status NOT_YET_RECRUITING

Isala Klinieken

Zwolle, PO Box 10400, Netherlands

Site Status RECRUITING

Catharina Ziekenhuis

Eindhoven, PO Box 1350, Netherlands

Site Status NOT_YET_RECRUITING

AMC

Amsterdam, PO Box 22660, Netherlands

Site Status NOT_YET_RECRUITING

VUMC

Amsterdam, PO Box 7057, Netherlands

Site Status NOT_YET_RECRUITING

UMC Utrecht

Utrecht, PO Box 85500, Netherlands

Site Status NOT_YET_RECRUITING

st Elizabeth Gasthuis

Tilburg, PO Box 90151, Netherlands

Site Status NOT_YET_RECRUITING

Countries

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Netherlands

Central Contacts

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Maaike M Bloemendal, Drs.

Role: CONTACT

Phone: 0031384247506

Email: [email protected]

Ben Cohlen, Dr.

Role: CONTACT

Phone: 0031384247570

Email: [email protected]

Facility Contacts

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Eugenie Kaaijk, dr.

Role: primary

Sabine Logtenberg

Role: backup

Maaike Bloemendal, Drs.

Role: primary

Henriette Hulsebos

Role: backup

Minouche van Rumste, dr.

Role: primary

Milou Peters

Role: backup

Fulco van der Veen, prof. dr.

Role: primary

Tessa de Vries

Role: backup

Cornelis Lambalk, prof. dr.

Role: primary

Angelique de Vos-Brouwer

Role: backup

Frank Broekmans, prof. dr.

Role: primary

Marian Kosterman

Role: backup

Jesper Smeenk, dr.

Role: primary

References

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Bensdorp AJ, Cohlen BJ, Heineman MJ, Vandekerckhove P. Intra-uterine insemination for male subfertility. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD000360. doi: 10.1002/14651858.CD000360.pub4.

Reference Type BACKGROUND
PMID: 17943739 (View on PubMed)

Verhulst SM, Cohlen BJ, Hughes E, Te Velde E, Heineman MJ. Intra-uterine insemination for unexplained subfertility. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD001838. doi: 10.1002/14651858.CD001838.pub3.

Reference Type BACKGROUND
PMID: 17054143 (View on PubMed)

Tummon IS, Asher LJ, Martin JS, Tulandi T. Randomized controlled trial of superovulation and insemination for infertility associated with minimal or mild endometriosis. Fertil Steril. 1997 Jul;68(1):8-12. doi: 10.1016/s0015-0282(97)81467-7.

Reference Type BACKGROUND
PMID: 9207576 (View on PubMed)

Freiesleben NL, Lossl K, Bogstad J, Bredkjaer HE, Toft B, Loft A, Bangsboll S, Pinborg A, Budtz-Jorgensen E, Andersen AN. Predictors of ovarian response in intrauterine insemination patients and development of a dosage nomogram. Reprod Biomed Online. 2008 Nov;17(5):632-41. doi: 10.1016/s1472-6483(10)60310-0.

Reference Type BACKGROUND
PMID: 18983747 (View on PubMed)

la Cour Freiesleben N, Lossl K, Bogstad J, Bredkjaer HE, Toft B, Rosendahl M, Loft A, Bangsboll S, Pinborg A, Nyboe Andersen A. Individual versus standard dose of rFSH in a mild stimulation protocol for intrauterine insemination: a randomized study. Hum Reprod. 2009 Oct;24(10):2523-30. doi: 10.1093/humrep/dep239. Epub 2009 Jul 14.

Reference Type BACKGROUND
PMID: 19602518 (View on PubMed)

Freiesleben Nl, Rosendahl M, Johannsen TH, Lossl K, Loft A, Bangsboll S, Friis-Hansen L, Pinborg A, Andersen AN. Prospective investigation of serum anti-Mullerian hormone concentration in ovulatory intrauterine insemination patients: a preliminary study. Reprod Biomed Online. 2010 May;20(5):582-7. doi: 10.1016/j.rbmo.2010.02.007. Epub 2010 Feb 12.

Reference Type BACKGROUND
PMID: 20303323 (View on PubMed)

Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, Behre HM, Haugen TB, Kruger T, Wang C, Mbizvo MT, Vogelsong KM. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010 May-Jun;16(3):231-45. doi: 10.1093/humupd/dmp048. Epub 2009 Nov 24.

Reference Type BACKGROUND
PMID: 19934213 (View on PubMed)

La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio AC, Stabile G, Volpe A. Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2010 Mar-Apr;16(2):113-30. doi: 10.1093/humupd/dmp036. Epub 2009 Sep 30.

Reference Type BACKGROUND
PMID: 19793843 (View on PubMed)

Nelson SM, Anderson RA, Broekmans FJ, Raine-Fenning N, Fleming R, La Marca A. Anti-Mullerian hormone: clairvoyance or crystal clear? Hum Reprod. 2012 Mar;27(3):631-6. doi: 10.1093/humrep/der446. Epub 2012 Jan 11.

Reference Type BACKGROUND
PMID: 22238112 (View on PubMed)

Rutten A, van Ballegooijen H, Broekmans F, Cohlen B; PRORAILS study group. Insights into ovarian response with a fixed low dose FSH stimulation in an IUI programme: the PRORAILS study. Hum Reprod. 2022 Jun 30;37(7):1440-1450. doi: 10.1093/humrep/deac076.

Reference Type DERIVED
PMID: 35460412 (View on PubMed)

Other Identifiers

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PRORAILS trial

Identifier Type: -

Identifier Source: org_study_id