potential benefit of r-hlh addition in patients aged 35 to 40 under ovarian stimulation treatment

Conditions: Infertility

Summary: this will be an exploratory, prospective, randomized, open-label and controlled trial to evaluate the potential benefit of r-hfsh:r-hlh 2:1 co-treatment starting from cos d1 versus r-hfsh alone in patients aged 35 to 40 under ovarian stimulation treatment. after signing informed consent form (icf), all eligible participants will be randomly assigned in a 1:1 ratio to either treatment or control group, and gnrh antagonist protocol will be used in both treatment and control groups.

this will be an exploratory, prospective, randomized, open-label and controlled trial to evaluate the potential benefit of r-hfsh:r-hlh 2:1 co-treatment starting from cos d1 versus r-hfsh alone in patients aged 35 to 40 under ovarian stimulation treatment. after signing informed consent form (icf), all eligible participants will be randomly assigned in a 1:1 ratio to either treatment or control group, and gnrh antagonist protocol will be used in both treatment and control groups. 1. treatment group: the r-hfsh starting dose will be based on the patient's profile and physician's experience. r-hlh will be added at a ratio of 2:1 starting from day 1 of r-hfsh administration; the dose of r-hfsh during cos will be adjusted by the physician based on clinical experience and the patient's ovarian response, and the r-hfsh: r-hlh dose will be 2:1, continuing to 24\~48 hours prior to trigger drug injection. 2. control group: r-hfsh alone will be administrated for ovarian stimulation. the r-hfsh starting dose will be based on the patient's profile and physician's experience. the dose of r-hfsh during cos will be adjusted by the physician based on clinical experience and the patient's ovarian response, continuing to 24\~48 hours prior to trigger drug injection. the estimated treatment duration is 11 days from the first day of cos until 24\~48 h prior to trigger drug injection, and this may vary depending on individual circumstances. follicular development, serum e2 and p levels will be monitored during cos according to the investigator site's art practice until the criteria to administer trigger drug are met to induce final oocyte maturation. trigger drug administration is to be performed according to the site's routine clinical practice. oocyte pick-up (opu), ivf/icsi, et, and luteal phase support (lps) will be performed according to the site's routine practice. lps will be started after oocyte retrieval in fresh embryo transfer.

Eligibility criteria:
inclusion criteria: * age 35 to 40 (including 40) * 18.5\<bmi\<28 kg/m2 * afc up to 14 * first or second art cycle * planned for ovarian stimulation with gnrh-antagonist for down-regulation * ejaculated sperm exclusion criteria: * contraindications to art treatment * history of two or more spontaneous miscarriages * history of two or more implantation failures after fresh or frozen-warmed embryo transfers * diagnosis of severe endometriosis * patients with endocrine and metabolic diseases (diabetes mellitus, hypogonadotropic amenorrhea, genital system tumors, hyperprolactinemia, etc.) * confirmed chromosomal abnormalities

Keywords: recombinant human lh recombinant human fsh ovarian stimulation treatment advanced maternal age population