Trial Outcomes & Findings for Ovulation Induction in Women With Clomiphene Citrate Resistant PCOS (NCT NCT01909141)

NCT ID: NCT01909141

Last Updated: 2015-10-20

Results Overview

Recruitment status

COMPLETED

Study phase

EARLY_PHASE1

Target enrollment

100 participants

Primary outcome timeframe

3 months

Results posted on

2015-10-20

Participant Flow

Participant milestones

Participant milestones
Measure
Arm 1:Letrozole-pioglitazone -Metformin Group
Arm 1 received letrozole 2.5 mg/day starting from the 3rd day of the cycle and for 5 days and (combined pioglitazone 15 mg+ metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using letrozole-pioglitazone-metformin: induction of ovulation was done for arm 1 for 3 consecutive cycles unless pregnancy occurred. transvaginal ultrasound: transvaginal ultrasound will be done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was calculated. day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Arm 2: Clomiphene Citrate-pioglitazone-metformin
Arm 2 received clomiphene citrate 100 mg/day starting from the 3rd day of the cycle for 5 days and (combined pioglitazone 15 mg + metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using clomiphene citrate-pioglitazone-metformin: induction of ovulation for arm 2 was done in 3 consecutive cycles unless pregnancy occurred. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was calculated. day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Overall Study
STARTED
50
50
Overall Study
COMPLETED
50
50
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Ovulation Induction in Women With Clomiphene Citrate Resistant PCOS

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm 1:Letrozole-pioglitazone -Metformin Group
n=50 Participants
Arm 1 received letrozole 2.5 mg/day starting from the 3rd day of the cycle and for 5 days and (combined pioglitazone 15 mg+ metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using letrozole-pioglitazone-metformin: induction of ovulation was done for arm 1 for 3 consecutive cycles unless pregnancy occurred. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was calculated. day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Arm 2: Clomiphene Citrate-pioglitazone-metformin
n=50 Participants
Arm 2 will received clomiphene citrate 100 mg/day starting from the 3rd day of the cycle for 5 days and (combined pioglitazone 15 mg + metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using clomiphene citrate-pioglitazone-metformin: induction of ovulation for arm 2 was done in 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was calculated. day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Total
n=100 Participants
Total of all reporting groups
Age, Continuous
25.8 years
STANDARD_DEVIATION 3.62 • n=5 Participants
26.58 years
STANDARD_DEVIATION 2.9 • n=7 Participants
26.19 years
STANDARD_DEVIATION 3.29 • n=5 Participants
Sex: Female, Male
Female
50 Participants
n=5 Participants
50 Participants
n=7 Participants
100 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
Egypt
50 participants
n=5 Participants
50 participants
n=7 Participants
100 participants
n=5 Participants
infertility period
2.67 years
STANDARD_DEVIATION 1.62 • n=5 Participants
3.07 years
STANDARD_DEVIATION 1.46 • n=7 Participants
2.87 years
STANDARD_DEVIATION 1.5 • n=5 Participants
BMI
26.45 kg/m^2
STANDARD_DEVIATION 2.84 • n=5 Participants
26.57 kg/m^2
STANDARD_DEVIATION 2.7 • n=7 Participants
26.51 kg/m^2
STANDARD_DEVIATION 2.75 • n=5 Participants
waist/hip ratio
0.838 ratio
STANDARD_DEVIATION 0.02 • n=5 Participants
0.837 ratio
STANDARD_DEVIATION 0.04 • n=7 Participants
0.837 ratio
STANDARD_DEVIATION 0.037 • n=5 Participants
systolic blood pressure
106.08 mmHg
STANDARD_DEVIATION 8.81 • n=5 Participants
107.04 mmHg
STANDARD_DEVIATION 8.97 • n=7 Participants
106.56 mmHg
STANDARD_DEVIATION 8.86 • n=5 Participants
diastolic blood pressure
69.6 mmHg
STANDARD_DEVIATION 5.31 • n=5 Participants
68.44 mmHg
STANDARD_DEVIATION 5.89 • n=7 Participants
69.02 mmHg
STANDARD_DEVIATION 5.61 • n=5 Participants
hirsutism
11 participants
n=5 Participants
10 participants
n=7 Participants
21 participants
n=5 Participants
acne
7 participants
n=5 Participants
4 participants
n=7 Participants
11 participants
n=5 Participants
ovarian volume
14.17 ml
STANDARD_DEVIATION 0.76 • n=5 Participants
14.58 ml
STANDARD_DEVIATION 1.42 • n=7 Participants
14.19 ml
STANDARD_DEVIATION 0.98 • n=5 Participants
FSH
5.71 mIU/L
STANDARD_DEVIATION 1.34 • n=5 Participants
5.68 mIU/L
STANDARD_DEVIATION 1.38 • n=7 Participants
5.7 mIU/L
STANDARD_DEVIATION 1.35 • n=5 Participants
LH
9.81 mIU/L
STANDARD_DEVIATION 3.16 • n=5 Participants
10.55 mIU/L
STANDARD_DEVIATION 3.25 • n=7 Participants
10.18 mIU/L
STANDARD_DEVIATION 3.21 • n=5 Participants
E2
49.83 Pmol/dL
STANDARD_DEVIATION 7.31 • n=5 Participants
47.75 Pmol/dL
STANDARD_DEVIATION 10.02 • n=7 Participants
48.24 Pmol/dL
STANDARD_DEVIATION 8.56 • n=5 Participants
prolactin
15.52 ng/ml
STANDARD_DEVIATION 4.84 • n=5 Participants
14.3 ng/ml
STANDARD_DEVIATION 5.6 • n=7 Participants
14.9 ng/ml
STANDARD_DEVIATION 5.24 • n=5 Participants
total testosterone
1.19 nmol/L
STANDARD_DEVIATION 0.25 • n=5 Participants
1.13 nmol/L
STANDARD_DEVIATION 0.2 • n=7 Participants
1.16 nmol/L
STANDARD_DEVIATION 0.23 • n=5 Participants
free testosterone
3.87 Pmol/dL
STANDARD_DEVIATION 0.61 • n=5 Participants
4.12 Pmol/dL
STANDARD_DEVIATION 1.17 • n=7 Participants
3.99 Pmol/dL
STANDARD_DEVIATION 0.94 • n=5 Participants
TSH
3.42 mIU/L
STANDARD_DEVIATION 0.61 • n=5 Participants
3.51 mIU/L
STANDARD_DEVIATION 0.44 • n=7 Participants
3.47 mIU/L
STANDARD_DEVIATION 0.53 • n=5 Participants
free T4
13.78 nmol/L
STANDARD_DEVIATION 0.84 • n=5 Participants
13.58 nmol/L
STANDARD_DEVIATION 0.45 • n=7 Participants
13.68 nmol/L
STANDARD_DEVIATION 0.68 • n=5 Participants

PRIMARY outcome

Timeframe: 3 months

Outcome measures

Outcome measures
Measure
Arm 1:Letrozole-pioglitazone -Metformin Group
n=50 Participants
Arm 1 receivde letrozole 2.5 mg/day starting from the 3rd day of the cycle and for 5 days and (combined pioglitazone 15 mg+ metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using letrozole-pioglitazone-metformin: induction of ovulation was be done for arm 1 for 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was caculated. day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Arm 2: Clomiphene Citrate-pioglitazone-metformin
n=50 Participants
Arm 2 received clomiphene citrate 100 mg/day starting from the 3rd day of the cycle for 5 days and (combined pioglitazone 15 mg + metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using clomiphene citrate-pioglitazone-metformin: induction of ovulation for arm 2 was done in 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was calculated day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Ovulation Rate
93 percentage of all cycles
108 percentage of all cycles

SECONDARY outcome

Timeframe: 3 months

Outcome measures

Outcome measures
Measure
Arm 1:Letrozole-pioglitazone -Metformin Group
n=50 Participants
Arm 1 receivde letrozole 2.5 mg/day starting from the 3rd day of the cycle and for 5 days and (combined pioglitazone 15 mg+ metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using letrozole-pioglitazone-metformin: induction of ovulation was be done for arm 1 for 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was caculated. day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Arm 2: Clomiphene Citrate-pioglitazone-metformin
n=50 Participants
Arm 2 received clomiphene citrate 100 mg/day starting from the 3rd day of the cycle for 5 days and (combined pioglitazone 15 mg + metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using clomiphene citrate-pioglitazone-metformin: induction of ovulation for arm 2 was done in 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was calculated day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Number of Follicles>18mm.
1.44 follicles
Standard Deviation 0.16
1.5 follicles
Standard Deviation 0.86

SECONDARY outcome

Timeframe: 3 months

Outcome measures

Outcome measures
Measure
Arm 1:Letrozole-pioglitazone -Metformin Group
n=50 Participants
Arm 1 receivde letrozole 2.5 mg/day starting from the 3rd day of the cycle and for 5 days and (combined pioglitazone 15 mg+ metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using letrozole-pioglitazone-metformin: induction of ovulation was be done for arm 1 for 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was caculated. day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Arm 2: Clomiphene Citrate-pioglitazone-metformin
n=50 Participants
Arm 2 received clomiphene citrate 100 mg/day starting from the 3rd day of the cycle for 5 days and (combined pioglitazone 15 mg + metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using clomiphene citrate-pioglitazone-metformin: induction of ovulation for arm 2 was done in 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was calculated day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Endometrial Thickness
10.56 mm
Standard Deviation 1.79
9.68 mm
Standard Deviation 1.39

SECONDARY outcome

Timeframe: 3 months

Outcome measures

Outcome measures
Measure
Arm 1:Letrozole-pioglitazone -Metformin Group
n=50 Participants
Arm 1 receivde letrozole 2.5 mg/day starting from the 3rd day of the cycle and for 5 days and (combined pioglitazone 15 mg+ metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using letrozole-pioglitazone-metformin: induction of ovulation was be done for arm 1 for 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was caculated. day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Arm 2: Clomiphene Citrate-pioglitazone-metformin
n=50 Participants
Arm 2 received clomiphene citrate 100 mg/day starting from the 3rd day of the cycle for 5 days and (combined pioglitazone 15 mg + metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using clomiphene citrate-pioglitazone-metformin: induction of ovulation for arm 2 was done in 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was calculated day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Pregnancy Rate
28 participants
24 participants

OTHER_PRE_SPECIFIED outcome

Timeframe: 3 months

serum creatinine was measured at the end of the study period (after 3 months) in both groups.

Outcome measures

Outcome measures
Measure
Arm 1:Letrozole-pioglitazone -Metformin Group
n=50 Participants
Arm 1 receivde letrozole 2.5 mg/day starting from the 3rd day of the cycle and for 5 days and (combined pioglitazone 15 mg+ metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using letrozole-pioglitazone-metformin: induction of ovulation was be done for arm 1 for 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was caculated. day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Arm 2: Clomiphene Citrate-pioglitazone-metformin
n=50 Participants
Arm 2 received clomiphene citrate 100 mg/day starting from the 3rd day of the cycle for 5 days and (combined pioglitazone 15 mg + metformin 850 mg) once daily from the first day of the cycle for 10 days. induction of ovulation using clomiphene citrate-pioglitazone-metformin: induction of ovulation for arm 2 was done in 3 consecutive cycles unless pregnancy occured. transvaginal ultrasound: transvaginal ultrasound was done starting from day 10 and every 48 hours until finding a follicle of \> 18 mm or till day 20 of the cycle body mass index (BMI) calculation: BMI was calculated day 3: follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), total testosterone: baseline hormonal assay (day 3 FSH, LH, TSH and total testosterone) were done for all women. serum estradiol (E2) was done on day of hCG administration for all women. serum progesterone on day 21 was done for all women.
Safety of Pioglitazone as Regards Serum Creatinine
0.62 mg/dL
Standard Deviation 0.04
0.57 mg/dL
Standard Deviation 0.03

Adverse Events

Arm 1:Letrozole-pioglitazone -Metformin Group

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Arm 2: Clomiphene Citrate-pioglitazone-metformin

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Ghada Abdel Fattah

Cairo University

Phone: 00201006513305

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place