A Prospective, Multi-centric Observational Study to Determine the Mono-bifollicular Development in Infertile Women Subjected to Ovulation Induction With Follitropin α

Study Overview
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Brief Summary
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This is a prospective and multicentric observational study to determine the real mono-bifollicular development rate that is obtained under normal care conditions following ovulation induction (OI) treatment with follitropin-alpha filled by mass prescribed in accordance with standard practice.

Detailed Description
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In women with infertility due to anovulation, the main purpose of ovulation induction (OI) consists in inducing the mono or bifollicular and the subsequent ovulation in order to achieve pregnancy. The availability of recombinant gonadotropins obtained using genetically engineered techniques has meant a decisive and clear pharmacological advancement. Use of recombinant human follicle stimulating hormone (r-hFSH) offers a greater effectiveness (greater number of follicles/ ovocytes and a higher pregnancy rate) and efficiency (fewer number of blisters, fewer stimulation days; fewer number of cancellations and complications) in programmed coitus and artificial insemination like in-vitro fertilisation (IVF)/intra cytoplasmic sperm injection (ICSI) techniques. Further advances in obtaining better products for ovarian stimulation has led to production of a recombinant FSH (follitropin alpha) filled by mass preparation. This hormone becomes the most consistent and precise gonadotropin due to improvements in its quantification process. Today, despite having accurate and modern tools for ovulation induction, in daily practice, doctors continue to fight against two old problems of assisted reproduction: multiple pregnancies and ovarian hyperstimulation syndrome (OHSS). Application of assisted reproduction techniques (ARTs) and the use of medication that induce ovulation, risk producing gestations and multiple births with a higher frequency than those observed in spontaneous gestations. One of the facts that result in the appearance of such problems is the high incidence of polycystic ovarian syndrome among the population of women who are infertile due to anovulation. These subjects are especially sensitive to ovarian stimulation, which leads to multiple follicular development, a higher risk of hyperstimulation and higher rates of multiple pregnancies. Therefore, it seems clear that the search for developing mono or bifollicular cycles is important in ovarian induction cycles, for the purpose of preventing the above mentioned multiple pregnancy problems and the risk of OHSS. The intent of this study was to figure out the real mono-bifollicular development rate that is obtained under normal care conditions following OI treatment with follitropin alpha filled by mass prescribed in accordance with standard practice. Therefore, a measure of the efficiency of the product for achieving the development of one or two follicles. Data was collected from 56 centres of the Autonomous Communities that accepted this observational study, until achieving a total of 410 ovulation induction cycles. OBJECTIVES Primary objective: To find the real proportion of cycles with mono-bifollicular development during the provision of care involving OI with follitropin alpha filled by mass Secondary objectives: To evaluate if the use of follitropin alpha filled by mass has other clinical benefits such as a reduction in the number of cancelled cycles, of the dosage and time required and adverse effects

Official Title
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Prospective Multi-centre Observational Study to Determine the Mono-bifollicular Development in Infertile Women Subjected to Ovulation Induction With Follitropin α

Conditions
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Ovulation Induction

Intervention / Treatment
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* Drug: Follitropin alpha (r-FSH)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Premenopausal women with infertility caused by anovulation, who wished to conceive and were included in an ovulation induction (OI) treatment protocol for intrauterine insemination or for programmed coitus Exclusion Criteria: Subjects with hypersensitivity to follitropin alpha, to FSH or to any of the excipients Subjects with hypothalamic or pituitary tumours Subjects with increase in the size of the ovaries or cysts that were not due to polycystic ovary disease Subjects with gynaecologic haemorrhages of unknown aetiology Subjects with ovarian, uterine or mammary carcinoma Subjects with primary ovarian failure Subjects with malformations of sex organs that were not compatible with pregnancy Subjects with uterine fibroid tumours that were not compatible with pregnancy
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: Follitropin alpha (r-FSH)|The dosage and administration of follitropin alpha was according to each centre's protocol and within technical specification recommendations.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Follicular development | Number and size of follicles as determined through transvaginal ultrasound | First 10 months from the inclusion of the subjects | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Secondary efficacy assessments | Duration of ovulation induction; total accumulated dosage of follitropin alpha; cycles cancelled due to insufficient response or due to risk of ovarian hyperstimulation; proportion of pregnancies | From baseline until the pregnancy or menstruation confirmation | 
| Safety assessments | Incidence of adverse occurrences, in particular OHSS; proportion of multiple pregnancies and local reaction at the injection point. | First 10 months from the inclusion of the subjects | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ovulation induction, Ovarian Hyperstimulation Syndrome, Pregnancy, Fertility