Clomifene Citrate as First Line Treatment in in Vitro Fertilization Cycles for Patients With Lower Ovarian Reserve (clomid)
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Purpose
Women with compromised ovarian reserve requiring in vitro fertilization (IVF) still represent a demanding challenge for clinicians. It has classically been claimed that using higher dosages of gonadotropins may overcome the scarce ovarian responsiveness to hyper-simulation and increase the chances of success. However, scientific evidence supporting this view is scanty and costs are inevitably much higher. In this study, the investigators hypothesized that similar chances of pregnancy may be achieved with a mild stimulation using exclusively Clomiphene citrate (CC).
| Condition | Intervention |
|---|---|
|
Infertility |
Drug: Clomifene Citrate Drug: GnRH analog and recombinant human FSH |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Patients With Reduced Ovarian Reserve and In Vitro Fertilization (IVF) Cycles. A Randomized Multicentric Comparison of a Protocol With High Doses of Gonadotropins and a Protocol With Clomiphene Citrate Only. Evaluation of Clinical Effectiveness and Economic Issues |
- live birth rate [ Time Frame: end of the study (28 months) ] [ Designated as safety issue: No ]
general "Live birth rate" will be recorded at the end of the study when all participants have performed their In vitro Fertilization (IVF) treatment.
Live birth rate per single patients will be recorded 4 weeks after embryo transfer when a intrauterine gestational sac is expected to be seen in case of pregnancy.
- ratio pregnancies/costs [ Time Frame: end of the study (28 months) ] [ Designated as safety issue: No ]at the end of the study the number of obtained pregnancies will be divided by the total costs of treatments in two groups. A cost in euros will be therefore estimated for every single pregnancy in both groups.
| Enrollment: | 289 |
| Study Start Date: | September 2008 |
| Study Completion Date: | December 2010 |
| Primary Completion Date: | December 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: High doses
Administration of high doses of gonadotrophins to stimulate ovarian follicular growth
|
Drug: GnRH analog and recombinant human FSH
daily subcutaneous 0.1 mg decapeptyl from day 1-2 of the menstrual cycle and recombinant human FSH 450 IU/die from day 3.
Other Names:
|
|
Experimental: Clomid
Administration of Clomiphene Citrate to obtain ovarian follicular growth
|
Drug: Clomifene Citrate
3x50 mg die for 5 days from day 3 to day 7 of the menstrual cycle
Other Name: clomid
|
Eligibility| Ages Eligible for Study: | 18 Years to 42 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- age 18-42 years
- infertility status
- Day 3 serum FSH > 12 IU/ml in at least two occasions or previous poor response (≤3 oocytes retrieved) to hyper-stimulation
Exclusion Criteria:
- contraindications to infertility treatments or pregnancy
Contacts and Locations| Italy | |
| Fondazione Ca' Granda Ospedale Maggiore Policlinico | |
| Milan, Italy, 20122 | |
| Principal Investigator: | guido ragni, md | Fondazione Ca' Granda Ospedale Maggiore Policlinico |
More Information
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Guido Ragni, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico |
| ClinicalTrials.gov Identifier: | NCT01389713 History of Changes |
| Other Study ID Numbers: | clomid re-007 |
| Study First Received: | July 1, 2011 |
| Last Updated: | July 11, 2011 |
| Health Authority: | Italy: Ethics Committee Italy: Ministry of Health Italy: National Institute of Health Italy: National Monitoring Centre for Clinical Trials - Ministry of Health |
Keywords provided by Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico:
|
ovarian reserve ovarian stimulation clomifene citrate high doses Follicle Stimulating Hormone (FSH) |
Additional relevant MeSH terms:
|
Infertility Genital Diseases, Male Genital Diseases, Female Citric Acid Clomiphene Follicle Stimulating Hormone Triptorelin Anticoagulants Hematologic Agents Therapeutic Uses Pharmacologic Actions Chelating Agents Molecular Mechanisms of Pharmacological Action Estrogen Antagonists |
Estrogen Receptor Modulators Hormone Antagonists Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Fertility Agents, Female Fertility Agents Reproductive Control Agents Selective Estrogen Receptor Modulators Hormones Luteolytic Agents Contraceptive Agents, Female Contraceptive Agents Antineoplastic Agents, Hormonal Antineoplastic Agents |
ClinicalTrials.gov processed this record on May 16, 2013