Clinical trial NCT06134479: Comparison of Sequential CFA vs CFA +rFSH for Elective Fertility Preservation.
Official title: Comparison of Sequential CFA vs CFA +rFSH for Elective Fertility Preservation.. The 2-shot Protocol.
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE3
Conditions: Fertility
Lead sponsor: Fundacion Dexeus
Sponsor class: OTHER
Collaborators: name: Organon
First posted: 2023-11-18
Enrollment: 194
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This randomized was designed as non-inferiority trial aiming to compare the number of MII oocytes with 2-shot of Corifollitropin alpha (CFA) sequential administration: 150μg at stimulation day (SD) 1 and 100μg at SD 5 and 1-shot of CFA administration 150μg at SD 1 following by rFSH 200IU daily from SD 8 in women undergoing elective fertility preservation in a progestin-primed ovarian stimulation (PPOS) protocol and GnRH-agonist (GnRH-a) triggering.


Eligibility criteria: Inclusion Criteria:

* AFC ≤20
* Anti-Mullerian hormone (AMH) ≤3ng/ml (AMH result of up to one year will be valid)
* Between 18 and 40 years old
* BMI \>18 and \<30 kg/m2
* Body weight \> 50 kg for \> 36 years
* Able to come to the Center to comply with the procedures of the study: blood tests, appointments and drug dispensation.

Exclusion Criteria:

* Medically indicated fertility preservation
* AFC \> 20
* Polycystic ovarian syndrome (PCOS) according to the Rotterdam criteria
* FSH ≥ 20
* History of untreated autoimmune, endocrine or metabolic disorders
* Contraindication for hormonal treatment
* Recent history of severe disease requiring regular treatment (clinically significant concurrent medical condition that could compromise subject safety or interfered with the trial assessment).

Primary outcomes:
measure: Number of MII oocytes retrieved
timeFrame: Trough study completion, an average of 10-20 days.
Secondary outcomes:
measure: Total number of oocytes retrieved
timeFrame: Trough study completion, an average of 10-20 days.
measure: FSH
timeFrame: Up to oocyte pickup, an average of 10-20 days.
measure: LH
timeFrame: Up to oocyte pickup, an average of 10-20 days.
measure: PROGESTERONE
timeFrame: Up to oocyte pickup, an average of 10-20 days.
measure: Estradiol
timeFrame: Up to oocyte pickup, an average of 10-20 days.
measure: OHSS
timeFrame: Until 15 days after day of oocyte pick-up
measure: FertiQoL
timeFrame: from stimulation day 1 until the day of oocyte pick-up,10-20 days after the beggining of the stimulation.
measure: Length of stimulation
timeFrame: up to 18 days
measure: Adverse events
timeFrame: up to 20days
Other outcomes:
Locations:
city: Barcelona
country: Spain
facility: Hospital Universitario Quiron Dexeus
Study officials:
References:
citation: Begueria R, Garcia D, Vassena R, Rodriguez A. Medroxyprogesterone acetate versus ganirelix in oocyte donation: a randomized controlled trial. Hum Reprod. 2019 May 1;34(5):872-880. doi: 10.1093/humrep/dez034.
citation: Benchabane M, Santulli P, Maignien C, Bourdon M, De Ziegler D, Chapron C, Gayet V. [Corifollitropin alfa compared to daily FSH in controlled ovarian stimulation for oocyte donors]. Gynecol Obstet Fertil Senol. 2017 Feb;45(2):83-88. doi: 10.1016/j.gofs.2016.12.022. Epub 2017 Feb 16. French.
citation: Blockeel C, Polyzos NP, Derksen L, De Brucker M, Vloeberghs V, van de Vijver A, De Vos M, Tournaye H. Administration of corifollitropin alfa on Day 2 versus Day 4 of the cycle in a GnRH antagonist protocol: a randomized controlled pilot study. Hum Reprod. 2014 Jul;29(7):1500-7. doi: 10.1093/humrep/deu105. Epub 2014 May 9.
citation: Cozzolino M, Vitagliano A, Cecchino GN, Ambrosini G, Garcia-Velasco JA. Corifollitropin alfa for ovarian stimulation in in vitro fertilization: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2019 Apr;111(4):722-733. doi: 10.1016/j.fertnstert.2018.11.047.
citation: Croxtall JD, McKeage K. Corifollitropin alfa: a review of its use in controlled ovarian stimulation for assisted reproduction. BioDrugs. 2011 Aug 1;25(4):243-54. doi: 10.2165/11206890-000000000-00000.
citation: Devroey P, Boostanfar R, Koper NP, Mannaerts BM, Ijzerman-Boon PC, Fauser BC; ENGAGE Investigators. A double-blind, non-inferiority RCT comparing corifollitropin alfa and recombinant FSH during the first seven days of ovarian stimulation using a GnRH antagonist protocol. Hum Reprod. 2009 Dec;24(12):3063-72. doi: 10.1093/humrep/dep291. Epub 2009 Aug 14.
citation: Devroey P, Polyzos NP, Blockeel C. An OHSS-Free Clinic by segmentation of IVF treatment. Hum Reprod. 2011 Oct;26(10):2593-7. doi: 10.1093/humrep/der251. Epub 2011 Aug 9.
citation: Drakopoulos P, Vuong TNL, Ho NAV, Vaiarelli A, Ho MT, Blockeel C, Camus M, Lam AT, van de Vijver A, Humaidan P, Tournaye H, Polyzos NP. Corifollitropin alfa followed by highly purified HMG versus recombinant FSH in young poor ovarian responders: a multicentre randomized controlled clinical trial. Hum Reprod. 2017 Nov 1;32(11):2225-2233. doi: 10.1093/humrep/dex296.
citation: Fusi FM, Zanga L, Arnoldi M, Melis S, Cappato M, Candeloro I, Di Pasqua A. Corifollitropin alfa for poor responders patients, a prospective randomized study. Reprod Biol Endocrinol. 2020 Jul 9;18(1):67. doi: 10.1186/s12958-020-00628-6.
citation: Giles J, Alama P, Gamiz P, Vidal C, Badia P, Pellicer A, Bosch E. Medroxyprogesterone acetate is a useful alternative to a gonadotropin-releasing hormone antagonist in oocyte donation: a randomized, controlled trial. Fertil Steril. 2021 Aug;116(2):404-412. doi: 10.1016/j.fertnstert.2021.02.036. Epub 2021 Apr 2.
citation: Hwang JL, Chen SU, Chen HJ, Chen HF, Yang YS, Chang CH, Seow KM, Tzeng CR, Lin YH. Feasibility of corifollitropin alfa/GnRH antagonist protocol combined with GnRH agonist triggering and freeze-all strategy in polycystic ovary syndrome patients. J Formos Med Assoc. 2018 Jun;117(6):535-540. doi: 10.1016/j.jfma.2017.05.009. Epub 2017 Aug 19.
citation: La Marca A, Capuzzo M. Use of progestins to inhibit spontaneous ovulation during ovarian stimulation: the beginning of a new era? Reprod Biomed Online. 2019 Aug;39(2):321-331. doi: 10.1016/j.rbmo.2019.03.212. Epub 2019 Mar 29.
citation: La Marca A, D'Ippolito G. Ovarian response markers lead to appropriate and effective use of corifollitropin alpha in assisted reproduction. Reprod Biomed Online. 2014 Feb;28(2):183-90. doi: 10.1016/j.rbmo.2013.10.012. Epub 2013 Oct 25.
citation: Ledger WL, Fauser BC, Devroey P, Zandvliet AS, Mannaerts BM. Corifollitropin alfa doses based on body weight: clinical overview of drug exposure and ovarian response. Reprod Biomed Online. 2011 Aug;23(2):150-9. doi: 10.1016/j.rbmo.2011.04.002. Epub 2011 Apr 15.
citation: Lerman T, Depenbusch M, Schultze-Mosgau A, von Otte S, Scheinhardt M, Koenig I, Kamischke A, Macek M, Schwennicke A, Segerer S, Griesinger G. Ovarian response to 150 microg corifollitropin alfa in a GnRH-antagonist multiple-dose protocol: a prospective cohort study. Reprod Biomed Online. 2017 May;34(5):534-540. doi: 10.1016/j.rbmo.2017.02.012. Epub 2017 Mar 2.
citation: Loutradis D, Vlismas A, Drakakis P. Corifollitropin alfa: a novel long-acting recombinant follicle-stimulating hormone agonist for controlled ovarian stimulation. Womens Health (Lond). 2010 Sep;6(5):655-64. doi: 10.2217/whe.10.56.
citation: Mahmoud Youssef MA, van Wely M, Aboulfoutouh I, El-Khyat W, van der Veen F, Al-Inany H. Is there a place for corifollitropin alfa in IVF/ICSI cycles? A systematic review and meta-analysis. Fertil Steril. 2012 Apr;97(4):876-85. doi: 10.1016/j.fertnstert.2012.01.092. Epub 2012 Jan 23.
citation: Martinez F, Clua E, Garcia S, Coroleu B, Polyzos NP, Barri PN. Does LH suppression by progesterone-primed ovarian stimulation compared with GnRH antagonist affect live birth rate among oocyte recipients? Reprod Biomed Online. 2020 May;40(5):661-667. doi: 10.1016/j.rbmo.2020.01.016. Epub 2020 Jan 25.
citation: Martinez F, Rodriguez-Purata J, Beatriz Rodriguez D, Clua E, Rodriguez I, Coroleu B. Desogestrel versus antagonist injections for LH suppression in oocyte donation cycles: a crossover study. Gynecol Endocrinol. 2019 Oct;35(10):878-883. doi: 10.1080/09513590.2019.1604661. Epub 2019 May 7.
citation: Massin N. New stimulation regimens: endogenous and exogenous progesterone use to block the LH surge during ovarian stimulation for IVF. Hum Reprod Update. 2017 Mar 1;23(2):211-220. doi: 10.1093/humupd/dmw047.
citation: Polyzos NP, Corona R, Van De Vijver A, Blockeel C, Drakopoulos P, Vloeberghs V, De Vos M, Camus M, Humaidan P, Tournaye H. Corifollitropin alfa followed by hpHMG in GnRH agonist protocols. Two prospective feasibility studies in poor ovarian responders. Gynecol Endocrinol. 2015;31(11):885-90. doi: 10.3109/09513590.2015.1065481. Epub 2015 Jul 14.
citation: Polyzos NP, Devos M, Humaidan P, Stoop D, Ortega-Hrepich C, Devroey P, Tournaye H. Corifollitropin alfa followed by rFSH in a GnRH antagonist protocol for poor ovarian responder patients: an observational pilot study. Fertil Steril. 2013 Feb;99(2):422-6. doi: 10.1016/j.fertnstert.2012.09.043. Epub 2012 Oct 16.
citation: Polyzos NP, Tournaye H, Guzman L, Camus M, Nelson SM. Predictors of ovarian response in women treated with corifollitropin alfa for in vitro fertilization/intracytoplasmic sperm injection. Fertil Steril. 2013 Aug;100(2):430-7. doi: 10.1016/j.fertnstert.2013.04.029. Epub 2013 May 10.
citation: Rombauts L, Talmor A. Corifollitropin alfa for female infertility. Expert Opin Biol Ther. 2012 Jan;12(1):107-12. doi: 10.1517/14712598.2012.641530. Epub 2011 Nov 30.
citation: Seyhan A, Ata B. The role of corifollitropin alfa in controlled ovarian stimulation for IVF in combination with GnRH antagonist. Int J Womens Health. 2011;3:243-55. doi: 10.2147/IJWH.S15002. Epub 2011 Aug 8.
citation: Tsakiridis I, Najdecki R, Tatsi P, Timotheou E, Kalinderi K, Michos G, Virgiliou A, Yarali H, Athanasiadis A, Papanikolaou EG. Evaluation of the safety and efficacy of corifollitropin alfa combined with GnRH agonist triggering in oocyte donation cycles. A prospective longitudinal study. JBRA Assist Reprod. 2020 Oct 6;24(4):436-441. doi: 10.5935/1518-0557.20200033.
citation: Vuong NL, Pham DT, Phung HT, Giang HN, Huynh GB, Nguyen TTL, Ho MT. Corifollitropin alfa vs recombinant FSH for controlled ovarian stimulation in women aged 35-42 years with a body weight >/=50 kg: a randomized controlled trial. Hum Reprod Open. 2017 Nov 28;2017(3):hox023. doi: 10.1093/hropen/hox023. eCollection 2017.
citation: Yovich JL, Keane KN, Borude G, Dhaliwal SS, Hinchliffe PM. Finding a place for corifollitropin within the PIVET FSH dosing algorithms. Reprod Biomed Online. 2018 Jan;36(1):47-58. doi: 10.1016/j.rbmo.2017.09.017. Epub 2017 Oct 31.