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This is a single center, open-label, randomized, parallel group, dose finding study to evaluate safety and efficacy of recombinant human luteinizing hormone (r-hLH, LHadi®), compared with urinary human chorionic gonadotrophin (u-hCG, Profasi®), both given subcutaneously, in inducing ovulation in infertile women undergoing stimulation of follicular growth with recombinant human follicle stimulating hormone (r-hFSH, Gonal-F®).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| r-hLH (825 International Units [IU]) | Experimental |
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| r-hLH (2750 IU) | Experimental |
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| r-hLH (5500 IU) | Experimental |
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| r-hLH (11000 IU) | Experimental |
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| r-hLH (22000 IU) | Experimental |
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| u-hCG (5000 IU) | Active Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| r-hFSH | Drug | Daily r-hFSH treatment will be administered subcutaneously at a starting dose according to the site's standard practice from Day 3-5 of menstrual cycle up to follicular development or 28 days. Dose can be altered according to ovarian response (reduced to 75 IU/day; increased to 225 IU/day). |
| Measure | Description | Time Frame |
|---|---|---|
| Ovulation rate | Day 4 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) | |
| Ratio of ruptured follicles per follicle with diameter greater than or equal to (>=) 15 millimeter (mm) | Day 4 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) | |
| Number of follicles with diameter greater than or equal to (>=) 11 millimeter (mm) | Day 4 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) | |
| Ratio of ruptured follicles per follicle with diameter greater than or equal to (>=) 11 millimeter (mm) | Day 4 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of participants with mono-follicular ovulation | Day 4 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) | |
| Number of participants with biochemical pregnancy | Day 25-30 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) |
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Inclusion Criteria:
Infertile woman wishing to conceive and justifying ovarian stimulation treatment with gonadotrophins for in vivo conception
Aged 20-40 years (inclusive)
Male partner with acceptable semen analysis for intra-uterine insemination, according to center's standard practice
Have the following hormone serum levels measured locally during early (Day 2-4) follicular phase (if menstruating) or at anytime (if not menstruating):
At least one patent tube, as assessed with hysterosalpingography (HSG), ultrasound (U/S) or laparoscopy performed within 3 years prior to beginning r-hFSH treatment
Uterine cavity without abnormalities which, in the Investigator's opinion, could impair embryo implantation or pregnancy evolution as assessed with HSG, hysteroscopy (HSC) or U/S performed within 3 years prior to beginning r-hFSH treatment
Body mass index (BMI) greater than or equal to 18 and less than or equal to 35 kilogram per square meter (kg/m^2)
Negative serum or urinary pregnancy test prior to beginning r-hFSH treatment
Be willing and able to comply with the protocol for the duration of the study
Have given written informed consent, prior to any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to their future medical care
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Medical Responsible | Merck Serono International SA | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Royal University Hospital | Saskatoon | Saskatchewan | Canada |
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| r-hLH | Drug | Ovulation triggering will be performed using a single injection of r-hLH injection subcutaneously at a dose of 825 or 2750 or 5500 or 11,000 or 22,000 IU as soon as follicles satisfy the criteria for follicular development, that is at least 1 follicle with diameter >= 18 mm, not more than 5 follicles with diameter >= 15 mm and with E2 levels less than 9000 picomoles per liter (pmol/L). |
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| u-hCG | Drug | Ovulation triggering will be performed using a single injection of 5000 IU of u-hCG as soon as follicles satisfy the criteria for follicular development, that is at least 1 follicle with diameter >= 18 mm, not more than 5 follicles with diameter >= 15 mm and with E2 levels less than 9000 picomoles per liter (pmol/L). |
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| Serum estradiol (E2) levels | Day 1, 2 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) |
| Serum androstenedione levels | Day 1, 2 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) |
| Serum total renin levels | Day 1, 2 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) |
| Serum vascular endothelial growth factor (VEGF) levels | Day 1, 2 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) |
| Endometrial thickness | Day 0, 1, 2, 3, 4 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) |
| Number of participants with clinical pregnancy | Day 25-30 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) |
| Serum progesterone (P4) levels | Day 1, 2 and 6-9 post r-hLH/u-hCG day (end of stimulation cycle [approximately 28 days]) |
| ID | Term |
|---|---|
| D007246 | Infertility |
| ID | Term |
|---|---|
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
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| ID | Term |
|---|---|
| C571801 | follitropin alfa |
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