Agonist Versus Classical HCG Trigger (Poor Responders, Normoresponders and High Responders)

NCT ID: NCT03307720

Last Updated: 2017-12-11

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

Clinical Phase

NA

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-18

Study Completion Date

2018-05-31

Brief Summary

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Agonist triggering in controlled ovarian stimulation protocols is being used during last years (among high responder patients to avoid OHSS).

Indeed, agonist triggering is more physiologic than HCG triggering. Investigators propose to compare the effectiveness of both types of trigger among three different subsets of patients:

1. Poor responders.
2. Normo-responders
3. High responders Comparing both the number and the quality of achieved oocytes.

Detailed Description

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During the last years, ovulation triggering in controlled ovarian stimulation protocols has been used specially to avoid hyperstimulation syndromes (OHSS). Indeed, the substitution of the classical HCG triggering by the agonist one, reduces almost to zero the risk of OHSS.

On the other hand poor responder patients to ovarian stimulation represent a challenge in assisted reproduction. Defining poor responders is not easy, but we can define them as those patients with less than 4 eggs obtained after oocyte retrieval.

Different strategies have been proposed to overcome this problem. In other words, to obtain more oocytes. These include an increase in FSH doses, an increase in FSH action by adding sensitizers agents.

Among the possible strategies, investigators propose the agonist triggering. HCG (classical) triggering represents the use of a LH-like product (with a prolonged action). The administration of a GnRH agonist provoke the production and liberation of both FSH and LH. Thus, the pro-ovulatory action is more physiologic , and possibly, more effective.

So, the use of a triggering protocol that nowadays is being used among high responders (thus reducing the OHSS risk) is proposed for both poor responder and normo-responder patients trying to achieve more oocytes, and specifically more mature oocytes.

Conditions

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Ovulation Induction In Vitro Fertilization (IVF) Infertility, Female Oocytes

Keywords

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agonist trigger Ovulation induction Controlled ovarian stimulation (COS) Poor responder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

IVF patients enrolled either to HCG or agonist trigger ovulation induction
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Poor responders. Classical trigger

Intervention: HCG trigger (Administration of recombinant HCG 250 UI subcutaneously 36 prior to oocyte retrieval.

Women scheduled for IVF treatment with 4 or less antral follicles in ultrasound assessment.

Group Type ACTIVE_COMPARATOR

Human chorionic gonadotropin

Intervention Type DRUG

Administration of Human chorionic gonadotropin (HCG) 250 IU subcutaneously , 36 hours before ovum pick-up in IVF treatments.

Poor responders. Agonist trigger

Intervention: Agonist trigger (administration of 0,2 mg of Triptoreline subcutaneously 36 hours prior to oocyte retrieval)

Women scheduled for IVF treatment with 4 or less antral follicles in ultrasound assessment.

Group Type EXPERIMENTAL

Gonadotropin Releasing Hormone Agonists (GNRH-A)

Intervention Type DRUG

Administration of a gonadotropin releasing hormone agonist (GnRH-a) (0,2 ml) subcutaneously, 36 hours before ovum pick-up in IVF treatments.

Normo responders. Classical trigger

Intervention: HCG trigger (Administration of recombinant HCG 250 UI subcutaneously 36 prior to oocyte retrieval.

Women scheduled for IVF treatment with more than 4 and less than 16 antral follicles in ultrasound assessment.

Group Type ACTIVE_COMPARATOR

Human chorionic gonadotropin

Intervention Type DRUG

Administration of Human chorionic gonadotropin (HCG) 250 IU subcutaneously , 36 hours before ovum pick-up in IVF treatments.

Normo responders. Agonist trigger

Intervention: Agonist trigger (administration of 0,2 mg of Triptoreline subcutaneously 36 hours prior to oocyte retrieval)

Women scheduled for IVF treatment with more than 4 and less than 16 antral follicles in ultrasound assessment.

Group Type EXPERIMENTAL

Gonadotropin Releasing Hormone Agonists (GNRH-A)

Intervention Type DRUG

Administration of a gonadotropin releasing hormone agonist (GnRH-a) (0,2 ml) subcutaneously, 36 hours before ovum pick-up in IVF treatments.

High responders. Classical trigger

Intervention: HCG trigger (Administration of recombinant HCG 250 UI subcutaneously 36 prior to oocyte retrieval.

Women scheduled for IVF treatment with more than 15 antral follicles in ultrasound assessment.

Group Type ACTIVE_COMPARATOR

Human chorionic gonadotropin

Intervention Type DRUG

Administration of Human chorionic gonadotropin (HCG) 250 IU subcutaneously , 36 hours before ovum pick-up in IVF treatments.

High responders. Agonist trigger

Intervention: Agonist trigger (administration of 0,2 mg of Triptoreline subcutaneously 36 hours prior to oocyte retrieval)

Women scheduled for IVF treatment with more than 15 antral follicles in ultrasound assessment.

Group Type EXPERIMENTAL

Gonadotropin Releasing Hormone Agonists (GNRH-A)

Intervention Type DRUG

Administration of a gonadotropin releasing hormone agonist (GnRH-a) (0,2 ml) subcutaneously, 36 hours before ovum pick-up in IVF treatments.

Interventions

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Gonadotropin Releasing Hormone Agonists (GNRH-A)

Administration of a gonadotropin releasing hormone agonist (GnRH-a) (0,2 ml) subcutaneously, 36 hours before ovum pick-up in IVF treatments.

Intervention Type DRUG

Human chorionic gonadotropin

Administration of Human chorionic gonadotropin (HCG) 250 IU subcutaneously , 36 hours before ovum pick-up in IVF treatments.

Intervention Type DRUG

Other Intervention Names

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Agonist trigger HCG trigger

Eligibility Criteria

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Inclusion Criteria

* Women scheduled for IVF treatment.
* First ovarian stimulation
* Two ovaries present
* No previous ovarian surgery
* No contraindication for any of the assigned treatments

Exclusion Criteria

* Previous ovarian surgery.
* Previous IVF treatments.
* Absence of one ovary
* Presence of an endometrioma
Minimum Eligible Age

18 Years

Maximum Eligible Age

48 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Ginegorama S.L.

OTHER

Sponsor Role lead

Responsible Party

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Gorka Barrenetxea

Professor of Gynecology & Obstetrics Universidad del País Vasco/Euskal Herriko Unibertsitatea. Medical Director of Reproducción Bilbao

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gorka Barrenetxea, PhD

Role: PRINCIPAL_INVESTIGATOR

Reproducción Bilbao. Universidad del País Vasco/Euskal Herriko Unibertsitatea

Jon Iker Arambarri, MD

Role: STUDY_CHAIR

Reproducción Bilbao. Universidad del País Vasco/Euskal Herriko Unibertsitatea

Locations

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Reproduccion Bilbao Assisted Reproduction Center

Bilbao, Bizkaia, Spain

Site Status

Countries

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Spain

Central Contacts

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Gorka Barrenetxea, PhD

Role: CONTACT

Phone: 00 34 605711484

Email: [email protected]

Amaia Garcia, PhD

Role: CONTACT

Email: [email protected]

Other Identifiers

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AGONIST TRIGGER

Identifier Type: -

Identifier Source: org_study_id