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Trial registered on ANZCTR
Registration number
ACTRN12614000242628
Ethics application status
Approved
Date submitted
30/01/2014
Date registered
6/03/2014
Date last updated
18/11/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Cycle outcome assessment of patients with Anti-Mullerian-Hormone (AMH) levels above 4ng/mL that are undergoing in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) with short antagonist ovarian stimulation
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Scientific title
Cycle Outcome Assessment of Patients with Anti-Mullerian-Hormone (AMH) levels above 4ng/mL that are Undergoing in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) with Short Antagonist Ovarian Stimulation
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Secondary ID [1]
284005
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none
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Universal Trial Number (UTN)
U1111-1152-7648
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Infertile patients requiring IVF/ICSI treatment with AMH level above 4ng/mL
291041
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Condition category
Condition code
Reproductive Health and Childbirth
291381
291381
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0
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Fertility including in vitro fertilisation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A cohort of infertile patients with AMH levels above 4ng/mL that require IVF/ICSI treatment will be included in this trial. After scheduling the treatment procedure, controlled ovarian stimulation (COH) using 150IU recombinant gonadotropin will be initiated. Beginning from the 6th day of the cycle, all patients will receive Gonadotropin releasing hormone (GnRH) antagonist shot 0,25mg daily untill final oocyte maturation (when leading follicle reaches diameter of 18 mm). Following COH, ovulation triggering (final oocyte maturation) will be planned and ultrasound guided oocyte retrieval process will be performed 34-36 hours after triggering ovulation for each patient. After obtaining enough number of mature oocytes per patient, intra cytoplasmic sperm injection will be performed on the retrieval day. Depending on the number and quality of embryos, embryo transfer procedure will be performed under ultrasound guidance for each patient. Finally, all cycle outcomes including hormone profiles, total duration of cycles, total gonadotropin consumption, peak estradiol levels, number of retrieved and good quality embryos, pregnancy rates and ovarian hyper stimulation syndrome rates will be determined. Estimated total duration of observation is 1 to 3 months.
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Intervention code [1]
288691
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Treatment: Other
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Comparator / control treatment
N/A
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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ovarian hyper stimulation syndrome (OHSS) incidence of patients undergoing IVF/ICSI treatment with short-antagonist protocol will be determined by both clinical and laboratory assessments. In order to define a case as OHSS; relevant symptoms such as dyspnea, bloating should be present and free fluid along with pelvis and Douglas pouch should be defined with ultrasound investigation. Additional laboratory parameters such as high hematocrit levels and liver enzymes could also helpful.
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Assessment method [1]
291372
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Timepoint [1]
291372
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approximately 3 months after the embryo transfer procedure for each patient
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Secondary outcome [1]
306620
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peak estradiol levels during cycle in terms of pg/mL per patient and per sub-groups along with the review of patient medical records
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Assessment method [1]
306620
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Timepoint [1]
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following completion of the cycle of all patients
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Secondary outcome [2]
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total number of retrieved oocytes (metaphase 2 oocytes) in numbers per patient along with the review of patient medical records
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Assessment method [2]
306954
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Timepoint [2]
306954
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following completion of the cycle of all patients
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Secondary outcome [3]
306955
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total number of mature (metaphase2) oocytes in numbers per patient along with the review of patient medical records
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Assessment method [3]
306955
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Timepoint [3]
306955
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following completion of the cycle of all patients
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Secondary outcome [4]
306956
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total amount of gonadotropin consumption in terms of IU per patient in cycle along with the review of patient medical records
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Assessment method [4]
306956
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Timepoint [4]
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following completion of the cycles of all patients
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Secondary outcome [5]
306957
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total duration of ovarian stimulation begining from second day of cycle till final oocyte maturation per patient in terms of days along with the review of patient medical records
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Assessment method [5]
306957
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Timepoint [5]
306957
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following completion of the cycles of all patients
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Secondary outcome [6]
306958
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implantation rate per patient (ratio of gestational sac to transferred embryos per patient) (%) along with the review of patient medical records
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Assessment method [6]
306958
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Timepoint [6]
306958
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following completion of the cycles of all patients
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Secondary outcome [7]
306959
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positive pregnancy test per patient in terms of serum B-hCG mIU/mL along with the review of patient medical records
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Assessment method [7]
306959
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Timepoint [7]
306959
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following completion of all cycles
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Eligibility
Key inclusion criteria
Patients with primary or secondary infertility who require IVF/ICSI procedure with Anti Mullerian Hormone levels above 4 ng/mL
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Minimum age
18
Years
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Maximum age
45
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
-patients with severe male factor infertility
-patients who will receive GnRH agonist for ovulation triggering due to excessive ovarian response
-inadequate or poor ovarian response to gonadotropins
-patients with AMH levels lower than 4 ng/mL
-patients with hypogonadotropic hypogonadism (WHO group 1 infertility)
-Patients with medical disorder that provides contraindication to assisted reproduction techniques.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
Approximately, 150 infertile patients will be allocated in the study to assess the ovarian hyperstimulation incidence and cycle outcomes per patient. After completion of IVF/ICSI cycles, primary and secondary objectives will be assessed. Following initial data assessment, all study outcomes including cycle dynamics and pregnancy rates will be compared between sub-groups as:
*AMH levels between 4 and 5 ng/mL, 5-6 ng/mL and above 6 ng/mL
*body mass index values below 20kg/m2, between 20-25 kg/m2, between 25-30 kg/m2 and above 30kg/m2
*HOMA index values (insulin resistance parameter): above and equal to 2,1 means resistant and below 2,1 means not resistant
Statistically significant parameters will be assessed between mentioned sub-groups.
Another statistical objective is to perform regression analysis to determine the factors that mostly influence biochemical pregnancy rates, clinical pregnancy rates and OHSS rates.
To predict 20% more OHSS cases in one of the mentioned sub-groups, total of 117 patients should be allocated within 0,05 type 1 error and 0,80 power. Power calculations was performed using NCSS PASS 2007.
Estimated total duration of the observation will be 3 months beginning from the allocation of first subject till collecting all cycle datas following completion of all cycles.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
17/03/2014
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Actual
20/03/2014
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Date of last participant enrolment
Anticipated
1/10/2014
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Actual
1/10/2014
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
150
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Accrual to date
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Final
120
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Recruitment outside Australia
Country [1]
5793
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Turkey
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State/province [1]
5793
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
288639
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Address [1]
288639
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Country [1]
288639
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Primary sponsor type
Individual
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Name
Recai Pabuccu, Proff., M.D.
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Address
Centrum Clinic IVF Center, Ankara
Ufuk University Faculty of Medicine, Ankara
Nenehatun caddesi No 59 GOP-Ankara
Turkey
06550
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Country
Turkey
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Secondary sponsor category [1]
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None
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Name [1]
287351
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Address [1]
287351
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Country [1]
287351
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Turgut Ozal University Faculty of Medicine
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Ethics committee address [1]
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Anadolu Bulvari 16/A Gimat - Yenimahalle / ANKARA 06370
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Ethics committee country [1]
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Turkey
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Date submitted for ethics approval [1]
290494
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23/01/2014
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Approval date [1]
290494
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24/01/2014
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Ethics approval number [1]
290494
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Summary
Brief summary
Infertile patients undergoing IVF/ICSI procedure with AMH levels greater than 4ng/mL represents clear risk for excessive ovarian response and ovarian hyper stimulation syndrome development under literature findings. Novel ovarian stimulation protocols and gonadotropin dose modifications have been proposed to prevent OHSS and achieve successful pregnancies so far. In the current study, fix 150 IU of gonadotropin stimulation along with fix day 6 antagonist protocol will be investigated in terms of excessive ovarian response and cycle outcomes in high responder infertile patients with AMH levels above 4ng/mL. Comparison of cycle outcomes will be performed between different sub-groups of AMH, body mass index and insulin resistancy situation. Also, most determining factors that may influence pregnancy and OHSS rates will be investigated.
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Trial website
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Trial related presentations / publications
there is currently no trials/publications available.
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Public notes
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Contacts
Principal investigator
Name
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Dr Emre Goksan Pabuccu
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Address
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Ufuk University Faculty of Medicine, Department of Obstetrics and Gynecology
Ankara-Turkey
06520
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Country
45910
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Turkey
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Phone
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+90 532 414 7844
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Fax
45910
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Email
45910
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[email protected]
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Contact person for public queries
Name
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Emre Goksan Pabuccu
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Address
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Ufuk University Faculty of Medicine, Department of Obstetrics and Gynecology
Ankara-Turkey
06520
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Country
45911
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Turkey
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Phone
45911
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+90 532 414 7844
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Fax
45911
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Email
45911
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[email protected]
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Contact person for scientific queries
Name
45912
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Recai Pabuccu
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Address
45912
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Ufuk University Faculty of Medicine, Department of Obstetrics and Gynecology
Ankara-Turkey
06520
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Country
45912
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Turkey
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Phone
45912
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+90 312 240 4000
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Fax
45912
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Email
45912
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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