PErsonalized Addition of Recombinant LH in Ovarian Stimulation
NCT ID: NCT04719000
Last Updated: 2024-05-22
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
RECRUITING
Clinical Phase
PHASE4
Total Enrollment
120 participants
Study Classification
INTERVENTIONAL
Study Start Date
2021-02-04
Study Completion Date
2025-11-30
Brief Summary
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Different ovarian stimulation regimens have shown to modify late follicular phase hormonal profiles. Besides, recent studies confirm that progesterone levels and their variation in the last day of oocyte maturation are affected by the dose of gonadotropins administered and by other factors. Progesterone elevation in late follicular phase of in vitro fertilization/intracytoplasmatic sperm injection (IVF/ICSI) cycles under ovarian stimulation compromises implantation rates due to a negative effect on the endometrium. However, there is still conflict in the literature questioning whether progesterone levels alone on the triggering day is a sufficient indicator as progesterone does not give the full picture of the ovarian functions, number of follicles as well as estrogen production that facilitate endometrial growth, thus some studies suggest that especially in aged and poor responders Progesterone/Estrogen (P4/E2) ratio has a better reflection (Progesterone (ng/mL) ×1,000/estradiol(pg/mL)) on the ovarian function.
The scope of the current pilot study is to compare serum progesterone levels as well as P4/E2 ratio on the day of ovulation triggering of women belonging to POSEIDON category group 2 who undergo a new ovarian stimulation with a dose of rhFSH 300 IU or 300 IU rhFSH plus 150 IU recombinant human luteinizing hormone (rhLH) in a gonadotropin-releasing hormone (GnRH) antagonist protocol.
The scope of the current pilot study is to compare serum progesterone levels as well as P4/E2 ratio on the day of ovulation triggering of women belonging to POSEIDON category group 2 who undergo a new ovarian stimulation with a dose of rhFSH 300 IU or 300 IU rhFSH plus 150 IU recombinant human luteinizing hormone (rhLH) in a gonadotropin-releasing hormone (GnRH) antagonist protocol.
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Detailed Description
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The main objective of assisted reproductive technology is to achieve a healthy child. Many aspects play a role in order to reach this outcome, including female age, the number of oocytes retrieved after ovarian stimulation, and endometrial receptivity. It has been clearly demonstrated that the number of oocytes obtained after ovarian stimulation for IVF/ICSI is a surrogate marker for the success rates following treatment. In general, a high number of oocytes retrieved is translated into a high number of embryos and eventually a high cumulative pregnancy rate (after the transfer of fresh and frozen-thawed embryos). However, although a higher number of oocytes and embryos may ensure an increase in the cumulative pregnancy rate, excessive ovarian response has been postulated to have a detrimental effect on the pregnancy rates following fresh embryo transfer given that raised serum estradiol and progesterone levels associated with a very excessive response may negatively affect embryo implantation.
In assisted reproductive technology (ART) cycles under the GnRH analog regimens, elevated progesterone serum levels at the late follicular phase, in good ovarian reserve women, is thought to be related to multiple follicular development and increased ovarian steroidogenic activity. However, for these patients elevated progesterone was shown to negatively affect the endometrium preparation and thereby implantation rate. Furthermore, in this group of women elevated progesterone is advocated to have no negative effect on the oocyte or embryo quality.
Importantly, more pronounced effect on unbalanced steroidogenesis has been correlated with age and ovarian reserve. For this patient population, serum progesterone/estradiol (P/E2) ratio on the day of human chorionic gonadotropin (hCG) administration was suggested as a more reliable marker predictor to cycle success than solely progesterone rise.
Based on the above-mentioned reports it is relatively clear that the aim of ovarian stimulation should be to result in high oocyte yield and educate endocrine milieu in order to maximize cumulative live birth rates. Nevertheless, despite this goal, a substantial proportion of patients do not manage to reach an optimal oocyte yield, resulting in lower pregnancy rates. These hypo-responders are associated with low follicles growth and reduced estrogen production leading to longer stimulations, and/or greater cumulative FSH doses.
Although, it is widely accepted that poor ovarian responders have significantly low live birth rates as compared with all other groups, an intermediate group of women with a "suboptimal ovarian response", has been recently proposed as a distinct group with significantly worse prognosis from women with normal response. In the same line, the POSEIDON group (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) has recently proposed a new stratification for patients with a reduced ovarian reserve or unexpected inappropriate ovarian response to ovarian stimulation, taken into account quantitative and qualitative parameters such as: i. Age and the expected aneuploidy rate; ii. Ovarian biomarkers (mainly antral follicle count (AFC) and anti-Müllerian hormone (AMH)), and iii. Ovarian response to a previous stimulation cycle.
One of the most interesting group of patients fulfilling the POSEIDON criteria is undeniably, POSEIDON GROUP 2: Women ≥35 years with adequate ovarian reserve parameters (AFC≥5; AMH≥1.2 ng/ml) and with unexpected poor or suboptimal ovarian response:
* Subgroup 2a: \<4 oocytes after standard ovarian stimulation.
* Subgroup 2b: 4-9 oocytes after standard ovarian stimulation.
Patients belonging to the POSEIDON group 2 are women with an objectively good ovarian reserve who do not manage to respond as expected following ovarian stimulation. Consequently, taking into account that these patients are women who do not respond in accordance to their ovarian reserve following ovarian stimulation, identifying the optimal treatment protocol for these women remains of paramount importance, namely these patients show slow response to FSH stimulation in terms of estradiol levels and follicle growth, require longer stimulations, and/or greater cumulative FSH doses despite their correct ovarian parameters.
In this regard, different gonadotropins used for ovarian stimulation have shown to affect differently late follicular phase hormonal levels. In fact, although the role of LH in the follicular phase of ovarian stimulation is still a matter of debate, it seems that IVF/ICSI cycles under LH activity reach lower progesterone levels on the day of ovulation triggering. However, no study has evaluated late follicular phase progesterone levels in Poseidon 2 group patients receiving recombinant FSH (rhFSH) versus rhFSH and rhLH for ovarian stimulation.
Taking into account the above-mentioned evidence, the investigators set out to perform a pilot study in women with suboptimal response (fulfilling Poseidon 2 criteria), in order to examine whether the addition of rhLH to rhFSH significantly changes late follicular phase progesterone levels as compared to rhFSH alone.
In assisted reproductive technology (ART) cycles under the GnRH analog regimens, elevated progesterone serum levels at the late follicular phase, in good ovarian reserve women, is thought to be related to multiple follicular development and increased ovarian steroidogenic activity. However, for these patients elevated progesterone was shown to negatively affect the endometrium preparation and thereby implantation rate. Furthermore, in this group of women elevated progesterone is advocated to have no negative effect on the oocyte or embryo quality.
Importantly, more pronounced effect on unbalanced steroidogenesis has been correlated with age and ovarian reserve. For this patient population, serum progesterone/estradiol (P/E2) ratio on the day of human chorionic gonadotropin (hCG) administration was suggested as a more reliable marker predictor to cycle success than solely progesterone rise.
Based on the above-mentioned reports it is relatively clear that the aim of ovarian stimulation should be to result in high oocyte yield and educate endocrine milieu in order to maximize cumulative live birth rates. Nevertheless, despite this goal, a substantial proportion of patients do not manage to reach an optimal oocyte yield, resulting in lower pregnancy rates. These hypo-responders are associated with low follicles growth and reduced estrogen production leading to longer stimulations, and/or greater cumulative FSH doses.
Although, it is widely accepted that poor ovarian responders have significantly low live birth rates as compared with all other groups, an intermediate group of women with a "suboptimal ovarian response", has been recently proposed as a distinct group with significantly worse prognosis from women with normal response. In the same line, the POSEIDON group (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) has recently proposed a new stratification for patients with a reduced ovarian reserve or unexpected inappropriate ovarian response to ovarian stimulation, taken into account quantitative and qualitative parameters such as: i. Age and the expected aneuploidy rate; ii. Ovarian biomarkers (mainly antral follicle count (AFC) and anti-Müllerian hormone (AMH)), and iii. Ovarian response to a previous stimulation cycle.
One of the most interesting group of patients fulfilling the POSEIDON criteria is undeniably, POSEIDON GROUP 2: Women ≥35 years with adequate ovarian reserve parameters (AFC≥5; AMH≥1.2 ng/ml) and with unexpected poor or suboptimal ovarian response:
* Subgroup 2a: \<4 oocytes after standard ovarian stimulation.
* Subgroup 2b: 4-9 oocytes after standard ovarian stimulation.
Patients belonging to the POSEIDON group 2 are women with an objectively good ovarian reserve who do not manage to respond as expected following ovarian stimulation. Consequently, taking into account that these patients are women who do not respond in accordance to their ovarian reserve following ovarian stimulation, identifying the optimal treatment protocol for these women remains of paramount importance, namely these patients show slow response to FSH stimulation in terms of estradiol levels and follicle growth, require longer stimulations, and/or greater cumulative FSH doses despite their correct ovarian parameters.
In this regard, different gonadotropins used for ovarian stimulation have shown to affect differently late follicular phase hormonal levels. In fact, although the role of LH in the follicular phase of ovarian stimulation is still a matter of debate, it seems that IVF/ICSI cycles under LH activity reach lower progesterone levels on the day of ovulation triggering. However, no study has evaluated late follicular phase progesterone levels in Poseidon 2 group patients receiving recombinant FSH (rhFSH) versus rhFSH and rhLH for ovarian stimulation.
Taking into account the above-mentioned evidence, the investigators set out to perform a pilot study in women with suboptimal response (fulfilling Poseidon 2 criteria), in order to examine whether the addition of rhLH to rhFSH significantly changes late follicular phase progesterone levels as compared to rhFSH alone.
Conditions
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Infertility
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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rhFSH+rhLH
Ovarian Stimulation with rhFSH+rhLH
Group Type
EXPERIMENTAL
rhFSH+rhLH
Intervention Type
DRUG
300 IU of rhFSH and 150 IU of rhLH (Pergoveris®) GnRH antagonist: cetrorelix 0.25 mg (Cetrotide® - Merck) GnRH antagonist: cetrorelix 0.25 mg (Cetrotide® - Merck) Recombinant human chorionic gonadotropin (rhCG) 6500 IU (Ovitrelle® - Merck) micronized progesterone 90 mg (Crinone 8% ® - Merck)
rhFSH
Ovarian Stimulation with rhFSH
Group Type
ACTIVE_COMPARATOR
rhFSH
Intervention Type
DRUG
300 IU rhFSH (Gonal-F®- Merck) GnRH antagonist: cetrorelix 0.25 mg (Cetrotide® - Merck) GnRH antagonist: cetrorelix 0.25 mg (Cetrotide® - Merck) rhCG 6500 IU (Ovitrelle® - Merck) micronized progesterone 90 mg (Crinone 8% ® - Merck)
Interventions
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rhFSH+rhLH
300 IU of rhFSH and 150 IU of rhLH (Pergoveris®) GnRH antagonist: cetrorelix 0.25 mg (Cetrotide® - Merck) GnRH antagonist: cetrorelix 0.25 mg (Cetrotide® - Merck) Recombinant human chorionic gonadotropin (rhCG) 6500 IU (Ovitrelle® - Merck) micronized progesterone 90 mg (Crinone 8% ® - Merck)
Intervention Type
DRUG
rhFSH
300 IU rhFSH (Gonal-F®- Merck) GnRH antagonist: cetrorelix 0.25 mg (Cetrotide® - Merck) GnRH antagonist: cetrorelix 0.25 mg (Cetrotide® - Merck) rhCG 6500 IU (Ovitrelle® - Merck) micronized progesterone 90 mg (Crinone 8% ® - Merck)
Intervention Type
DRUG
Eligibility Criteria
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Inclusion Criteria
* Able and willing to sign the Patient Consent Form and adhere to study visitation schedule.
* ≥ 35 years ≤40 years old.
* AFC ≥5 and or AMH ≥1.2 ng/mL.
* \<4 or 4-9 oocytes retrieved in a previous IVF/ICSI cycle with a starting dose of ≤225 IU with any gonadotropin under a GnRH antagonist protocol.
* Up to 3 previous ovarian stimulation cycles with a starting dose of ≤225 IU in which dose adjustments during stimulation did not exceed 300 IU.
* Ovarian stimulation for IVF/ICSI
* ≥ 35 years ≤40 years old.
* AFC ≥5 and or AMH ≥1.2 ng/mL.
* \<4 or 4-9 oocytes retrieved in a previous IVF/ICSI cycle with a starting dose of ≤225 IU with any gonadotropin under a GnRH antagonist protocol.
* Up to 3 previous ovarian stimulation cycles with a starting dose of ≤225 IU in which dose adjustments during stimulation did not exceed 300 IU.
* Ovarian stimulation for IVF/ICSI
Exclusion Criteria
* Poor ovarian responders according to the Bologna criteria.
* Polycystic ovary syndrome (PCOS) patients according to the Rotterdam criteria.
* AFC\>20.
* Age \>40 or \<35 years old.
* Women with \>10 oocytes retrieved in a previous IVF/ICSI cycle with 150-225 IU starting dose.
* Women who required dose adjustments during stimulation \>300 IU with any gonadotropin in their previous cycle
* Uterine abnormalities.
* Recent history of any current untreated endocrine abnormality.
* Unilateral or bilateral hydrosalpinx (visible on ultrasound scan (USS), unless clipped).
* Contraindications for the use of medicine used for ovarian stimulation (gonadotropins, GnRH antagonist, progesterone vaginal gel)
* Recent history of severe disease requiring regular treatment (Clinically significant concurrent medical condition that could compromise subject safety or interfered with the trial assessment and patients with any contraindication to pregnancy).
* Preimplantation Genetic Testing for Aneuploidies (PGT-a).
* Testicular Sperm Aspiration or Testicular Sperm Extraction (TESA or TESE)
* Polycystic ovary syndrome (PCOS) patients according to the Rotterdam criteria.
* AFC\>20.
* Age \>40 or \<35 years old.
* Women with \>10 oocytes retrieved in a previous IVF/ICSI cycle with 150-225 IU starting dose.
* Women who required dose adjustments during stimulation \>300 IU with any gonadotropin in their previous cycle
* Uterine abnormalities.
* Recent history of any current untreated endocrine abnormality.
* Unilateral or bilateral hydrosalpinx (visible on ultrasound scan (USS), unless clipped).
* Contraindications for the use of medicine used for ovarian stimulation (gonadotropins, GnRH antagonist, progesterone vaginal gel)
* Recent history of severe disease requiring regular treatment (Clinically significant concurrent medical condition that could compromise subject safety or interfered with the trial assessment and patients with any contraindication to pregnancy).
* Preimplantation Genetic Testing for Aneuploidies (PGT-a).
* Testicular Sperm Aspiration or Testicular Sperm Extraction (TESA or TESE)
Minimum Eligible Age
35 Years
Maximum Eligible Age
40 Years
Eligible Sex
FEMALE
Accepts Healthy Volunteers
No
Sponsors
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Merck, S.L., Spain
INDUSTRY
Sponsor Role
collaborator
Fundación Santiago Dexeus Font
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Nikolaos P Polyzos, MD PhD
Role: STUDY_CHAIR
Hospital Universitari Dexeus
Locations
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Hospital Universitario Quiron Dexeus
Barcelona, , Spain
Site Status
RECRUITING
Countries
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Spain
Central Contacts
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Facility Contacts
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References
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Esteves SC, Khastgir G, Shah J, Murdia K, Gupta SM, Rao DG, Dash S, Ingale K, Patil M, Moideen K, Thakor P, Dewda P. Association Between Progesterone Elevation on the Day of Human Chronic Gonadotropin Trigger and Pregnancy Outcomes After Fresh Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles. Front Endocrinol (Lausanne). 2018 Apr 26;9:201. doi: 10.3389/fendo.2018.00201. eCollection 2018.
Reference Type
BACKGROUND
Fatemi HM, Van Vaerenbergh I. Significance of premature progesterone rise in IVF. Curr Opin Obstet Gynecol. 2015 Jun;27(3):242-8. doi: 10.1097/GCO.0000000000000172.
Reference Type
BACKGROUND
Huang Y, Wang EY, Du QY, Xiong YJ, Guo XY, Yu YP, Sun YP. Progesterone elevation on the day of human chorionic gonadotropin administration adversely affects the outcome of IVF with transferred embryos at different developmental stages. Reprod Biol Endocrinol. 2015 Aug 4;13:82. doi: 10.1186/s12958-015-0075-3.
Reference Type
BACKGROUND
Joo BS, Park SH, An BM, Kim KS, Moon SE, Moon HS. Serum estradiol levels during controlled ovarian hyperstimulation influence the pregnancy outcome of in vitro fertilization in a concentration-dependent manner. Fertil Steril. 2010 Feb;93(2):442-6. doi: 10.1016/j.fertnstert.2009.02.066. Epub 2009 Apr 25.
Reference Type
BACKGROUND
Lawrenz B, Fatemi HM. Effect of progesterone elevation in follicular phase of IVF-cycles on the endometrial receptivity. Reprod Biomed Online. 2017 Apr;34(4):422-428. doi: 10.1016/j.rbmo.2017.01.011. Epub 2017 Jan 24.
Reference Type
BACKGROUND
Mitwally MF, Bhakoo HS, Crickard K, Sullivan MW, Batt RE, Yeh J. Estradiol production during controlled ovarian hyperstimulation correlates with treatment outcome in women undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2006 Sep;86(3):588-96. doi: 10.1016/j.fertnstert.2006.02.086. Epub 2006 Jun 30.
Reference Type
BACKGROUND
Valbuena D, Martin J, de Pablo JL, Remohi J, Pellicer A, Simon C. Increasing levels of estradiol are deleterious to embryonic implantation because they directly affect the embryo. Fertil Steril. 2001 Nov;76(5):962-8. doi: 10.1016/s0015-0282(01)02018-0.
Reference Type
BACKGROUND
Racca A, De Munck N, Santos-Ribeiro S, Drakopoulos P, Errazuriz J, Galvao A, Popovic-Todorovic B, Mackens S, De Vos M, Verheyen G, Tournaye H, Blockeel C. Do we need to measure progesterone in oocyte donation cycles? A retrospective analysis evaluating cumulative live birth rates and embryo quality. Hum Reprod. 2020 Jan 1;35(1):167-174. doi: 10.1093/humrep/dez238.
Reference Type
BACKGROUND
Younis JS. The role of progesterone/estradiol ratio in exploring the mechanism of late follicular progesterone elevation in low ovarian reserve women. Med Hypotheses. 2019 Apr;125:126-128. doi: 10.1016/j.mehy.2019.02.047. Epub 2019 Feb 28.
Reference Type
BACKGROUND
Lin YJ, Lan KC, Huang FJ, Lin PY, Chiang HJ, Kung FT. Reproducibility and clinical significance of pre-ovulatory serum progesterone level and progesterone/estradiol ratio on the day of human chorionic gonadotropin administration in infertile women undergoing repeated in vitro fertilization cycles. Reprod Biol Endocrinol. 2015 May 13;13:41. doi: 10.1186/s12958-015-0037-9.
Reference Type
BACKGROUND
Grynberg M, Labrosse J. Understanding Follicular Output Rate (FORT) and its Implications for POSEIDON Criteria. Front Endocrinol (Lausanne). 2019 Apr 16;10:246. doi: 10.3389/fendo.2019.00246. eCollection 2019.
Reference Type
BACKGROUND
Polyzos NP, Nwoye M, Corona R, Blockeel C, Stoop D, Haentjens P, Camus M, Tournaye H. Live birth rates in Bologna poor responders treated with ovarian stimulation for IVF/ICSI. Reprod Biomed Online. 2014 Apr;28(4):469-74. doi: 10.1016/j.rbmo.2013.11.010. Epub 2013 Dec 4.
Reference Type
BACKGROUND
Polyzos NP, Sunkara SK. Sub-optimal responders following controlled ovarian stimulation: an overlooked group? Hum Reprod. 2015 Sep;30(9):2005-8. doi: 10.1093/humrep/dev149. Epub 2015 Jul 21.
Reference Type
BACKGROUND
Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Hum Reprod. 2011 Jul;26(7):1768-74. doi: 10.1093/humrep/der106. Epub 2011 May 10.
Reference Type
BACKGROUND
Poseidon Group (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number); Alviggi C, Andersen CY, Buehler K, Conforti A, De Placido G, Esteves SC, Fischer R, Galliano D, Polyzos NP, Sunkara SK, Ubaldi FM, Humaidan P. A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept. Fertil Steril. 2016 Jun;105(6):1452-3. doi: 10.1016/j.fertnstert.2016.02.005. Epub 2016 Feb 26. No abstract available.
Reference Type
BACKGROUND
Humaidan P, Alviggi C, Fischer R, Esteves SC. The novel POSEIDON stratification of 'Low prognosis patients in Assisted Reproductive Technology' and its proposed marker of successful outcome. F1000Res. 2016 Dec 23;5:2911. doi: 10.12688/f1000research.10382.1. eCollection 2016.
Reference Type
BACKGROUND
Andersen AN, Devroey P, Arce JC. Clinical outcome following stimulation with highly purified hMG or recombinant FSH in patients undergoing IVF: a randomized assessor-blind controlled trial. Hum Reprod. 2006 Dec;21(12):3217-27. doi: 10.1093/humrep/del284. Epub 2006 Jul 27.
Reference Type
BACKGROUND
Smitz J, Andersen AN, Devroey P, Arce JC; MERIT Group. Endocrine profile in serum and follicular fluid differs after ovarian stimulation with HP-hMG or recombinant FSH in IVF patients. Hum Reprod. 2007 Mar;22(3):676-87. doi: 10.1093/humrep/del445. Epub 2006 Nov 16.
Reference Type
BACKGROUND
Vuong TN, Phung HT, Ho MT. Recombinant follicle-stimulating hormone and recombinant luteinizing hormone versus recombinant follicle-stimulating hormone alone during GnRH antagonist ovarian stimulation in patients aged >/=35 years: a randomized controlled trial. Hum Reprod. 2015 May;30(5):1188-95. doi: 10.1093/humrep/dev038. Epub 2015 Mar 3.
Reference Type
BACKGROUND
Al-Azemi M, Kyrou D, Kolibianakis EM, Humaidan P, Van Vaerenbergh I, Devroey P, Fatemi HM. Elevated progesterone during ovarian stimulation for IVF. Reprod Biomed Online. 2012 Apr;24(4):381-8. doi: 10.1016/j.rbmo.2012.01.010. Epub 2012 Jan 24.
Reference Type
BACKGROUND
Bungum L, Franssohn F, Bungum M, Humaidan P, Giwercman A. The circadian variation in Anti-Mullerian hormone in patients with polycystic ovary syndrome differs significantly from normally ovulating women. PLoS One. 2013 Sep 4;8(9):e68223. doi: 10.1371/journal.pone.0068223. eCollection 2013.
Reference Type
BACKGROUND
Gonzalez-Foruria I, Rodriguez I, Martinez F, Rodriguez-Purata J, Montoya P, Rodriguez D, Nicolau J, Coroleu B, Barri PN, Polyzos NP. Clinically significant intra-day variability of serum progesterone levels during the final day of oocyte maturation: a prospective study with repeated measurements. Hum Reprod. 2019 Aug 1;34(8):1551-1558. doi: 10.1093/humrep/dez091.
Reference Type
BACKGROUND
Griesinger G, Mannaerts B, Andersen CY, Witjes H, Kolibianakis EM, Gordon K. Progesterone elevation does not compromise pregnancy rates in high responders: a pooled analysis of in vitro fertilization patients treated with recombinant follicle-stimulating hormone/gonadotropin-releasing hormone antagonist in six trials. Fertil Steril. 2013 Dec;100(6):1622-8.e1-3. doi: 10.1016/j.fertnstert.2013.08.045. Epub 2013 Sep 29.
Reference Type
BACKGROUND
Griesinger G, Venetis CA, Tarlatzis B, Kolibianakis EM. To pill or not to pill in GnRH-antagonist cycles: the answer is in the data already! Reprod Biomed Online. 2015 Jul;31(1):6-8. doi: 10.1016/j.rbmo.2015.04.001. Epub 2015 Apr 9.
Reference Type
BACKGROUND
Golan A, Weissman A. Symposium: Update on prediction and management of OHSS. A modern classification of OHSS. Reprod Biomed Online. 2009 Jul;19(1):28-32. doi: 10.1016/s1472-6483(10)60042-9.
Reference Type
BACKGROUND
Bosch E, Vidal C, Labarta E, Simon C, Remohi J, Pellicer A. Highly purified hMG versus recombinant FSH in ovarian hyperstimulation with GnRH antagonists--a randomized study. Hum Reprod. 2008 Oct;23(10):2346-51. doi: 10.1093/humrep/den220. Epub 2008 Jun 25.
Reference Type
BACKGROUND
Related Links
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http://dexeus.com
Department of Obstetrics, Gynaecology and Reproduction Hospital Universitari Quirón Dexeus
Other Identifiers
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FSD-RHLH-2019-08
Identifier Type: -
Identifier Source: org_study_id
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Luteal Supplementation With Rec-LH After GnRH-agonist Triggering in In Vitro (IVF)
NCT00954811
UNKNOWN
PHASE4
Luteal Phase Supplementation With Recombinant LH After GnRh Agonist Oocytes Triggering in Women at Risk of OHSS
NCT02200952
COMPLETED
Influence of PRGF (Plasma Rich in Growth Factors) Puncture in Ovaries With Low Follicular Reservetechniques
NCT02992756
TERMINATED
PHASE3
Vaginal Progesterone Supplementation in Women With PCOS Undergoing Ovulation Induction With Letrozole
NCT03440359
COMPLETED
PHASE2/PHASE3
Individual Versus Standard Follicle Stimulating Hormone Dose for Controlled Ovarian Stimulation and Insemination
NCT00374634
COMPLETED
PHASE4