Possible Action of Resveratrol in Improving the Outcomes of IVF/ICSI in Couples With Unexplained Infertility
NCT ID: NCT06481696
Last Updated: 2024-07-01
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
NA
Total Enrollment
90 participants
Study Classification
INTERVENTIONAL
Study Start Date
2024-06-01
Study Completion Date
2025-12-31
Brief Summary
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Based on available evidence and given the potential beneficial effects of resveratrol in folliculogenesis and in oocyte development, the investigators designed a randomized, controlled, double-blind, single-center trial, whose objective will be the comparison of biological and clinical outcomes of resveratrol supplement in women undergoing IVF/ICSI cycles for unexplained infertility.
To the knowledge of the investigators, no study has been published on the potential effect of resveratrol on IVF/ICSI outcomes considering couples with this infertility diagnosis, which may be the natural target of this integrative treatment because the process of folliculogenesis and oocyte maturation cannot be routinely investigated. An alteration of these biological mechanisms could be the unrecognized cause of part of the unexplained infertility and treatment with resveratrol could result in significant clinical improvement for the patients enrolled in the study.
In more details, the main objective of this randomized, placebo-controlled, double-blind, single-center trial will be the evaluation of the possible effect of resveratrol in determining a better follicle development in patients with unexplained infertility undergoing controlled ovarian stimulation (COS) for IVF/ICSI.
Infertile female patients with normal ovarian reserve will be treated according to clinical practice and the difference between expected (through AFC) and retrieved oocytes will be assessed in relation to use of resveratrol.
To the knowledge of the investigators, no study has been published on the potential effect of resveratrol on IVF/ICSI outcomes considering couples with this infertility diagnosis, which may be the natural target of this integrative treatment because the process of folliculogenesis and oocyte maturation cannot be routinely investigated. An alteration of these biological mechanisms could be the unrecognized cause of part of the unexplained infertility and treatment with resveratrol could result in significant clinical improvement for the patients enrolled in the study.
In more details, the main objective of this randomized, placebo-controlled, double-blind, single-center trial will be the evaluation of the possible effect of resveratrol in determining a better follicle development in patients with unexplained infertility undergoing controlled ovarian stimulation (COS) for IVF/ICSI.
Infertile female patients with normal ovarian reserve will be treated according to clinical practice and the difference between expected (through AFC) and retrieved oocytes will be assessed in relation to use of resveratrol.
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Detailed Description
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On the basis of the last estimates, the global lifetime prevalence of infertility is 17.5%, which means that approximately one in six people have experienced infertility at some stage in their lives.
Despite an improvement in conventional diagnostic investigations, still today, around 25% of the causes of couple infertility remain unexplained.
In fact, several crucial moments of the human reproductive process cannot be studied and, therefore, specific reproductive alterations remain undiagnosed. Just thinking of the process of ovarian folliculogenesis, oocyte development, embryonic implantation, all ones real "biological mysteries".
Among these different biological aspects, it is known that the oocyte quality is the main predictor of clinical pregnancy after IVF/ICSI. Indeed, oocyte maturation process influences the embryo development and, consequently, the embryo viability. Although the mechanisms that determine a good quality oocyte are not known, nevertheless energy-dependent processes are supposed to play a major role in oocyte development. These processes are mediated by mitochondria, whose concentration in oocytes is the highest among the other cells of human body. The oocyte nuclear and cytoplasmic maturation is strictly connected with the growth of granulosa cells (GCs). These cells surround the oocyte and establish a functional bidirectional cross-talk with the oocyte itself through gap junctions and paracrine factors. During folliculogenesis, GCs increase the consumption of glucose and metabolize glucose into pyruvate which passes to the oocyte. All this determines an increase in the energy supply to the oocyte itself, demonstrated by the increase in ATP production, which allows the latter cell to prepare for fertilization and the first stages of embryonic development which, as known, is totally oocyte dependent .
Resveratrol seems to be able to fit into this area of cellular functioning. It is a natural polyphenol, widespread in foods, plants, drinks and it seems to induce GCs proliferation through an anti-apoptotic effect in a SIRT1-dependent manner. Furthermore, in GCs, resveratrol reduces the oxidative stress, increases the mitochondria biogenesis and the intracellular ATP levels, determining a high energy availability which favours the oocyte growth. Resveratrol seems to reduce in rat granulosa cells the expression of Vascular Endothelial Growth Factor (VEGF), implicated in angiogenesis and vascular permeability, potentially showing a protective effect on the risk of Ovarian Hyperstimulation Syndrome (OHSS), a life-threatening condition associated with ovarian stimulation, whose VEGF is the main mediator.
A recent clinical randomized trial showed that a pre-treatment of 3 months with resveratrol, in women affected by couple infertility and undergoing ICSI, was associated with a higher number of retrieved and mature oocytes, a higher fertilization rate, a higher number of blastocysts per patient and a higher number of surplus cryopreserved embryos per patient, even if no significant effect was observed in clinical pregnancies and live birth rates.
Based on this last evidence and given the potential beneficial effects of resveratrol in folliculogenesis and in oocyte development, the investigators designed a randomized, controlled, double-blind, single-center trial, whose objective will be the comparison of biological and clinical outcomes of resveratrol supplement in women undergoing IVF/ICSI cycles for unexplained infertility.
To the knowledge of the investigators, no study has been published on the potential effect of resveratrol on IVF/ICSI outcomes considering couples with this infertility diagnosis, which may be the natural target of this integrative treatment because the process of folliculogenesis and oocyte maturation cannot be routinely investigated. An alteration of these biological mechanisms could be the unrecognized cause of part of the unexplained infertility and treatment with resveratrol could result in significant clinical improvement for the patients enrolled in the study.
In more details, the main objective of this randomized, placebo-controlled, double-blind, single-center trial will be the evaluation of the possible effect of resveratrol in determining a better follicle development in patients with unexplained infertility undergoing controlled ovarian stimulation (COS) for IVF/ICSI.
Infertile female patients with normal ovarian reserve will be treated according to clinical practice and the difference between expected (through AFC) and retrieved oocytes will be assessed in relation to use of resveratrol.
DESIGN AND METHODOLOGY:
Couples affected by unexplained infertility will be enrolled. The definition of unexplained infertility is the following: infertility in couples with apparently normal ovarian function, fallopian tubes, uterus, cervix and pelvis, age ≤ 40 years and with adequate coital frequency; and apparently normal testicular function, genito-urinary anatomy and a normal ejaculate.
All patients will be randomized for no treatment (placebo Group - only folic acid) and for treatment of resveratrol (Study group) with a 1:1 ratio. The randomization list, generated by a software, will be managed by a nurse not directly involved in the study and will give the patients the drugs for all duration of treatment. Neither the physicians/embryologists neither the patients will be aware of the content of the boxes of drugs (folic acid or resveratrol) (Double blind design).
The duration of treatment will be at least 65 days before the starting of stimulation (from the stage of pre-antral follicles) and until the day of oocyte pick up.
All the AFC determinations will be performed by the same two physicians from 2nd to 6th day of the cycle, in one of the last three months before the starting of stimulation. All the follicles ranging from 2 to 10 mm will be recorded (distinguishing between the follicles ranging from 2 to 5 mm and those ranging from 6 to 10 mm).
COS will be carried out by daily injections of rFSH (Gonal F; Merck Serono, Italy) and will be started on the 2nd/3rd day of the cycle and continued until the day of induction of oocyte maturation. The pituitary suppression will be obtained by the administration of the GnRH antagonist ganirelix (0.25 mg per day, Fyremadel, Ferring S.p.A.), which will be started from the 6th day of the ovarian stimulation until the day of induction of oocyte maturation.
Follicular development will be monitored after 5 days of treatment and thereafter at least every 2 days. Monitoring will consist of: a) transvaginal ultrasound scan to evaluate the number and maximum diameter of ovarian follicles and the endometrial thickness; b) the dosage of 17β-oestradiol, LH and progesterone only on the day of induction of oocyte maturation. The transvaginal ultrasound for monitoring will be performed by the same two physicians.
Highly purified urinary hCG (Gonasi HP, IBSA Farmaceutici, Italy) 10.000 IU, subcutaneously or intramuscularly, will be used to induce final oocyte maturation when two or more follicles of ≥16 mm in diameter will be observed and will be administered 35.5-36 h before planned oocyte retrieval. In case of OHSS risk, the final oocyte maturation will be obtained by using a GnRH agonist (Triptorelin, Decapeptyl 0.1 mg, Ipsen S.p.A., Italy) 0.3 mg subcutaneously, and the oocyte retrieval will be planned with the same modalities described above; in this case, all the embryos obtained will be cryopreserved.
No difference in the number of oocytes retrieved was shown comparing these two different modalities of triggering the final oocyte maturation (Haahr et al., 2017).
The trigger of oocyte maturation will not be achieved in case of inability to reach at least 2 follicles ≥16 mm.
The oocyte pick ups will be performed by the two physicians with the highest level of expertise.
Fresh transfer of embryos will be performed on the second, third or fifth day after retrieving the oocytes.
In case of OHSS risk and/or in case of progesterone rise on the day of hCG administration (≥1.5 ng/ml), all the embryos will be cryopreserved. The couples with all frozen embryos will be considered for the analysis of the endpoints.
SAMPLE SIZE CALCULATION:
To pursuit the aims of the present study protocol, a priori sample size calculation was conducted to determine the minimal number of participants required. Data available in the literature indicate in average a difference of 1.5 in the no. of pre-ovulatory follicles (≥16mm) between the group treated with resveratrol and the control group, with an average increase of 15% in favour of the study group. Thus, considering a conservative difference of 10%, which is equivalent to a large effect size of d=0.80, a power (1- β) of 95%, an alpha of 0.05, a two-tails t-test, and a ratio of 1:1 between the two groups, a total of 90 subjects (45 for each group) would be needed to verify a significant difference in primary outcome between the two groups.
Despite an improvement in conventional diagnostic investigations, still today, around 25% of the causes of couple infertility remain unexplained.
In fact, several crucial moments of the human reproductive process cannot be studied and, therefore, specific reproductive alterations remain undiagnosed. Just thinking of the process of ovarian folliculogenesis, oocyte development, embryonic implantation, all ones real "biological mysteries".
Among these different biological aspects, it is known that the oocyte quality is the main predictor of clinical pregnancy after IVF/ICSI. Indeed, oocyte maturation process influences the embryo development and, consequently, the embryo viability. Although the mechanisms that determine a good quality oocyte are not known, nevertheless energy-dependent processes are supposed to play a major role in oocyte development. These processes are mediated by mitochondria, whose concentration in oocytes is the highest among the other cells of human body. The oocyte nuclear and cytoplasmic maturation is strictly connected with the growth of granulosa cells (GCs). These cells surround the oocyte and establish a functional bidirectional cross-talk with the oocyte itself through gap junctions and paracrine factors. During folliculogenesis, GCs increase the consumption of glucose and metabolize glucose into pyruvate which passes to the oocyte. All this determines an increase in the energy supply to the oocyte itself, demonstrated by the increase in ATP production, which allows the latter cell to prepare for fertilization and the first stages of embryonic development which, as known, is totally oocyte dependent .
Resveratrol seems to be able to fit into this area of cellular functioning. It is a natural polyphenol, widespread in foods, plants, drinks and it seems to induce GCs proliferation through an anti-apoptotic effect in a SIRT1-dependent manner. Furthermore, in GCs, resveratrol reduces the oxidative stress, increases the mitochondria biogenesis and the intracellular ATP levels, determining a high energy availability which favours the oocyte growth. Resveratrol seems to reduce in rat granulosa cells the expression of Vascular Endothelial Growth Factor (VEGF), implicated in angiogenesis and vascular permeability, potentially showing a protective effect on the risk of Ovarian Hyperstimulation Syndrome (OHSS), a life-threatening condition associated with ovarian stimulation, whose VEGF is the main mediator.
A recent clinical randomized trial showed that a pre-treatment of 3 months with resveratrol, in women affected by couple infertility and undergoing ICSI, was associated with a higher number of retrieved and mature oocytes, a higher fertilization rate, a higher number of blastocysts per patient and a higher number of surplus cryopreserved embryos per patient, even if no significant effect was observed in clinical pregnancies and live birth rates.
Based on this last evidence and given the potential beneficial effects of resveratrol in folliculogenesis and in oocyte development, the investigators designed a randomized, controlled, double-blind, single-center trial, whose objective will be the comparison of biological and clinical outcomes of resveratrol supplement in women undergoing IVF/ICSI cycles for unexplained infertility.
To the knowledge of the investigators, no study has been published on the potential effect of resveratrol on IVF/ICSI outcomes considering couples with this infertility diagnosis, which may be the natural target of this integrative treatment because the process of folliculogenesis and oocyte maturation cannot be routinely investigated. An alteration of these biological mechanisms could be the unrecognized cause of part of the unexplained infertility and treatment with resveratrol could result in significant clinical improvement for the patients enrolled in the study.
In more details, the main objective of this randomized, placebo-controlled, double-blind, single-center trial will be the evaluation of the possible effect of resveratrol in determining a better follicle development in patients with unexplained infertility undergoing controlled ovarian stimulation (COS) for IVF/ICSI.
Infertile female patients with normal ovarian reserve will be treated according to clinical practice and the difference between expected (through AFC) and retrieved oocytes will be assessed in relation to use of resveratrol.
DESIGN AND METHODOLOGY:
Couples affected by unexplained infertility will be enrolled. The definition of unexplained infertility is the following: infertility in couples with apparently normal ovarian function, fallopian tubes, uterus, cervix and pelvis, age ≤ 40 years and with adequate coital frequency; and apparently normal testicular function, genito-urinary anatomy and a normal ejaculate.
All patients will be randomized for no treatment (placebo Group - only folic acid) and for treatment of resveratrol (Study group) with a 1:1 ratio. The randomization list, generated by a software, will be managed by a nurse not directly involved in the study and will give the patients the drugs for all duration of treatment. Neither the physicians/embryologists neither the patients will be aware of the content of the boxes of drugs (folic acid or resveratrol) (Double blind design).
The duration of treatment will be at least 65 days before the starting of stimulation (from the stage of pre-antral follicles) and until the day of oocyte pick up.
All the AFC determinations will be performed by the same two physicians from 2nd to 6th day of the cycle, in one of the last three months before the starting of stimulation. All the follicles ranging from 2 to 10 mm will be recorded (distinguishing between the follicles ranging from 2 to 5 mm and those ranging from 6 to 10 mm).
COS will be carried out by daily injections of rFSH (Gonal F; Merck Serono, Italy) and will be started on the 2nd/3rd day of the cycle and continued until the day of induction of oocyte maturation. The pituitary suppression will be obtained by the administration of the GnRH antagonist ganirelix (0.25 mg per day, Fyremadel, Ferring S.p.A.), which will be started from the 6th day of the ovarian stimulation until the day of induction of oocyte maturation.
Follicular development will be monitored after 5 days of treatment and thereafter at least every 2 days. Monitoring will consist of: a) transvaginal ultrasound scan to evaluate the number and maximum diameter of ovarian follicles and the endometrial thickness; b) the dosage of 17β-oestradiol, LH and progesterone only on the day of induction of oocyte maturation. The transvaginal ultrasound for monitoring will be performed by the same two physicians.
Highly purified urinary hCG (Gonasi HP, IBSA Farmaceutici, Italy) 10.000 IU, subcutaneously or intramuscularly, will be used to induce final oocyte maturation when two or more follicles of ≥16 mm in diameter will be observed and will be administered 35.5-36 h before planned oocyte retrieval. In case of OHSS risk, the final oocyte maturation will be obtained by using a GnRH agonist (Triptorelin, Decapeptyl 0.1 mg, Ipsen S.p.A., Italy) 0.3 mg subcutaneously, and the oocyte retrieval will be planned with the same modalities described above; in this case, all the embryos obtained will be cryopreserved.
No difference in the number of oocytes retrieved was shown comparing these two different modalities of triggering the final oocyte maturation (Haahr et al., 2017).
The trigger of oocyte maturation will not be achieved in case of inability to reach at least 2 follicles ≥16 mm.
The oocyte pick ups will be performed by the two physicians with the highest level of expertise.
Fresh transfer of embryos will be performed on the second, third or fifth day after retrieving the oocytes.
In case of OHSS risk and/or in case of progesterone rise on the day of hCG administration (≥1.5 ng/ml), all the embryos will be cryopreserved. The couples with all frozen embryos will be considered for the analysis of the endpoints.
SAMPLE SIZE CALCULATION:
To pursuit the aims of the present study protocol, a priori sample size calculation was conducted to determine the minimal number of participants required. Data available in the literature indicate in average a difference of 1.5 in the no. of pre-ovulatory follicles (≥16mm) between the group treated with resveratrol and the control group, with an average increase of 15% in favour of the study group. Thus, considering a conservative difference of 10%, which is equivalent to a large effect size of d=0.80, a power (1- β) of 95%, an alpha of 0.05, a two-tails t-test, and a ratio of 1:1 between the two groups, a total of 90 subjects (45 for each group) would be needed to verify a significant difference in primary outcome between the two groups.
Conditions
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Unexplained Infertility
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
TREATMENT
Blinding Strategy
DOUBLE
Participants
Caregivers
Study Groups
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Resveratrol group
Treatment with resveratrol, folic acid and vitamins B6, B12, D. The duration of treatment will be at least 65 days before the starting of stimulation (from the stage of pre-antral follicles) and until the day of oocyte pick up.
Group Type
ACTIVE_COMPARATOR
Resveratrol-based multivitamin supplement
Intervention Type
DIETARY_SUPPLEMENT
Natural polyphenol and vitamins
IVF/ICSI
Intervention Type
PROCEDURE
In vitro fertilization/IntraCytoplasmic Sperm Injection
Follitropin Alfa
Intervention Type
DRUG
Controlled Ovarian Stimulation
Ganirelix Acetate 0.5 MG/ML [Fyremadel]
Intervention Type
DRUG
GnRH Antagonist
hCG 10.000 IU or triptorelin 0,3 mg, subcutaneously
Intervention Type
DRUG
For the induction of oocyte maturation
Placebo group
Treatment with folic acid only. The duration of treatment will be at least 65 days before the starting of stimulation (from the stage of pre-antral follicles) and until the day of oocyte pick up.
Group Type
ACTIVE_COMPARATOR
Folic acid
Intervention Type
DIETARY_SUPPLEMENT
Supplementation with folic acid at the standard dosage of 0.4 mg/die
IVF/ICSI
Intervention Type
PROCEDURE
In vitro fertilization/IntraCytoplasmic Sperm Injection
Follitropin Alfa
Intervention Type
DRUG
Controlled Ovarian Stimulation
Ganirelix Acetate 0.5 MG/ML [Fyremadel]
Intervention Type
DRUG
GnRH Antagonist
hCG 10.000 IU or triptorelin 0,3 mg, subcutaneously
Intervention Type
DRUG
For the induction of oocyte maturation
Interventions
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Resveratrol-based multivitamin supplement
Natural polyphenol and vitamins
Intervention Type
DIETARY_SUPPLEMENT
Folic acid
Supplementation with folic acid at the standard dosage of 0.4 mg/die
Intervention Type
DIETARY_SUPPLEMENT
IVF/ICSI
In vitro fertilization/IntraCytoplasmic Sperm Injection
Intervention Type
PROCEDURE
Follitropin Alfa
Controlled Ovarian Stimulation
Intervention Type
DRUG
Ganirelix Acetate 0.5 MG/ML [Fyremadel]
GnRH Antagonist
Intervention Type
DRUG
hCG 10.000 IU or triptorelin 0,3 mg, subcutaneously
For the induction of oocyte maturation
Intervention Type
DRUG
Other Intervention Names
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Genante
In vitro fertilization
Gonal-F
Gonasi or Decapeptyl
Eligibility Criteria
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Inclusion Criteria
* Female age 18-40 years
* Female BMI 18-30 kg/m2
* normal menstrual cycles (26-35 days)
* duration of infertility at least 18 months
* normal semen parameters as established by WHO laboratory manual for the examination and processing of human semen Sixth edition
* normal US evaluation of male genital anatomy
* normal FSH, LH, Prolactin, Total Testosterone, Estradiol in male partner
* bilateral tubal patency established by 3-D HyFoSy or HSG
* normal uterine cavity evaluated by 3-D HyFoSy or HSG or hysteroscopy
* absence of antibodies Anti-Chlamyidia Trachomatis IgG/IgM
* failed intrauterine inseminations or couple's decision to refuse intrauterine inseminations
* Female BMI 18-30 kg/m2
* normal menstrual cycles (26-35 days)
* duration of infertility at least 18 months
* normal semen parameters as established by WHO laboratory manual for the examination and processing of human semen Sixth edition
* normal US evaluation of male genital anatomy
* normal FSH, LH, Prolactin, Total Testosterone, Estradiol in male partner
* bilateral tubal patency established by 3-D HyFoSy or HSG
* normal uterine cavity evaluated by 3-D HyFoSy or HSG or hysteroscopy
* absence of antibodies Anti-Chlamyidia Trachomatis IgG/IgM
* failed intrauterine inseminations or couple's decision to refuse intrauterine inseminations
Exclusion Criteria
* ≥15 cigarettes per day at least in one of the partners
* irregular menstrual cycles
* poor ovarian response (on the basis of the "Bologna" Criteria)
* inaccessible ovaries
* severe endometriosis (stage III-IV of the ASRM revised classification)
* significant systemic diseases
* heterologous fertilization
* previous pelvic surgery
* presence of ovarian cysts
* polycystic ovary syndrome
* use of hormonal contraception in the previous 3 months
* use of gonadotrophins in the previous 3 months
* III stage varicocele
* irregular menstrual cycles
* poor ovarian response (on the basis of the "Bologna" Criteria)
* inaccessible ovaries
* severe endometriosis (stage III-IV of the ASRM revised classification)
* significant systemic diseases
* heterologous fertilization
* previous pelvic surgery
* presence of ovarian cysts
* polycystic ovary syndrome
* use of hormonal contraception in the previous 3 months
* use of gonadotrophins in the previous 3 months
* III stage varicocele
Minimum Eligible Age
18 Years
Maximum Eligible Age
40 Years
Eligible Sex
FEMALE
Accepts Healthy Volunteers
No
Sponsors
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Andros Day Surgery Clinic
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Adolfo Allegra, MD
Role: PRINCIPAL_INVESTIGATOR
ANDROS Day Surgery Clinic Palermo, Italy
Locations
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ANDROS Day Surgery Clinic
Palermo, , Italy
Site Status
RECRUITING
Countries
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Italy
Central Contacts
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Facility Contacts
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References
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Gerli S, Della Morte C, Ceccobelli M, Mariani M, Favilli A, Leonardi L, Lanti A, Iannitti RG, Fioretti B. Biological and clinical effects of a resveratrol-based multivitamin supplement on intracytoplasmic sperm injection cycles: a single-center, randomized controlled trial. J Matern Fetal Neonatal Med. 2022 Dec;35(25):7640-7648. doi: 10.1080/14767058.2021.1958313. Epub 2021 Aug 1.
Reference Type
RESULT
Han Y, Luo H, Wang H, Cai J, Zhang Y. SIRT1 induces resistance to apoptosis in human granulosa cells by activating the ERK pathway and inhibiting NF-kappaB signaling with anti-inflammatory functions. Apoptosis. 2017 Oct;22(10):1260-1272. doi: 10.1007/s10495-017-1386-y.
Reference Type
RESULT
May-Panloup P, Chretien MF, Malthiery Y, Reynier P. Mitochondrial DNA in the oocyte and the developing embryo. Curr Top Dev Biol. 2007;77:51-83. doi: 10.1016/S0070-2153(06)77003-X.
Reference Type
RESULT
Ortega I, Duleba AJ. Ovarian actions of resveratrol. Ann N Y Acad Sci. 2015 Aug;1348(1):86-96. doi: 10.1111/nyas.12875.
Reference Type
RESULT
Ragonese F, Monarca L, De Luca A, Mancinelli L, Mariani M, Corbucci C, Gerli S, Iannitti RG, Leonardi L, Fioretti B. Resveratrol depolarizes the membrane potential in human granulosa cells and promotes mitochondrial biogenesis. Fertil Steril. 2021 Apr;115(4):1063-1073. doi: 10.1016/j.fertnstert.2020.08.016. Epub 2021 Jan 22.
Reference Type
RESULT
Guideline Group on Unexplained Infertility; Romualdi D, Ata B, Bhattacharya S, Bosch E, Costello M, Gersak K, Homburg R, Mincheva M, Norman RJ, Piltonen T, Dos Santos-Ribeiro S, Scicluna D, Somers S, Sunkara SK, Verhoeve HR, Le Clef N. Evidence-based guideline: unexplained infertilitydagger. Hum Reprod. 2023 Oct 3;38(10):1881-1890. doi: 10.1093/humrep/dead150.
Reference Type
RESULT
Cox CM, Thoma ME, Tchangalova N, Mburu G, Bornstein MJ, Johnson CL, Kiarie J. Infertility prevalence and the methods of estimation from 1990 to 2021: a systematic review and meta-analysis. Hum Reprod Open. 2022 Nov 12;2022(4):hoac051. doi: 10.1093/hropen/hoac051. eCollection 2022.
Reference Type
RESULT
Other Identifiers
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ANDROS-01-24
Identifier Type: -
Identifier Source: org_study_id
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Individual Versus Standard Follicle Stimulating Hormone Dose for Controlled Ovarian Stimulation and Insemination
NCT00374634
COMPLETED
PHASE4
Ovarian Stimulation With Recombinant Gonadotropins vs. Human Menopausal Gonadotropin in In Vitro Fertilization
NCT02322398
COMPLETED
Impact of FSH Dosage During Ovarian Stimulation for IVF/ICSI in Granulosa Cells
NCT05330130
COMPLETED
PHASE1
Short Versus Long Protocol for IVF and IVF+ICSI
NCT00756028
COMPLETED
PHASE4
Age Versus Ovarian Reserve Markers Based Therapy in IVF (IVF)/Intracytoplasmic Sperm Injection (ICSI) Cycles
NCT01816789
TERMINATED
PHASE4
GnRH Agonist Administration in the Luteal Phase of ICSI-ET Cycles
NCT00516490
COMPLETED
NA
Impact of Gonadotrophin Releasing Hormone Analogues on Oocyte and Embryo Quality
NCT03139474
UNKNOWN
PHASE2/PHASE3
Follow-up Protocol on the Outcome of Frozen-thawed Embryo Transfer Cycles From Clinical Trial P05690 (P05711)
NCT00702546
COMPLETED
Role of Heparin in Poor Responders Undergoing In Vitro Fertilisation
NCT01315093
COMPLETED
PHASE2/PHASE3
Maximal Stimulation and Delayed Fertilization for Diminished Ovarian Reserve: a Randomized Pilot Study
NCT01921166
COMPLETED
PHASE4