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InfertilityNCT02746562

Study Comparing Outcomes Between Conventional IVF and a "Freeze-all"-Strategy in Assisted Reproductive Technology

A study testing Freeze all in people with Infertility, run by Anja Bisgaard Pinborg at 2 sites in Denmark.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of this study is to compare conventional fresh embryo transfer with a "freeze all and transfer later strategy" in assisted reproductive technology in terms of ongoing pregnancy rates, live birth rates as well as perinatal outcomes. Read more about this study

Who is it for?
Ages 18 to 39 years, women only
Conditions the study is for
Infertility
What is being tested?
Freeze all
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
424 participants
Where
2 sitesDenmark
Study dates
May 2016to Sep 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 39 years
  • Women only
  • No healthy volunteers
  • Adult

Who may be able to join

  • AMH (Anti-Müllerian hormone) > 6.28 pmol/L (Roche Elecsys assay)
  • Female age 18 years to less than 40 years
  • 1, 2 or 3 IVF/ICSI cycle with oocyte aspiration
  • Regular menstrual cycle between 24 and 35 days
  • BMI between 18 and 35
  • Two ovaries
  • Can and will sign informed consent

Who cannot join

  • Women who do not fulfil the inclusion criteria
  • Endometriosis stage III to IV
  • Ovarian cysts with diameter > 30 mm at day of start of stimulation
  • Submucosal fibroids
  • Women with severe co-morbidity (IDDM, NIDDM, gastrointestinal, cardiovascular, pulmonary, liver or kidney disease)
  • Dysregulation of thyroid disease
Show all 11Show fewer
  • Not danish or English speaking women
  • Contraindications or allergies to use of Gonadotrophins or GnRH antagonists
  • TESA (testicular sperm aspiration)
  • OD (oocyte donation)
  • Previous inclusion in the study

Trial locations and contacts

2 sites in 1 country.

Sacha Stormlund, MD contact

sacha.stormlund.01@regionh.dk

Anja Bisgaard Pinborg, MD, DMSc contact

anja.bisgaard.pinborg@regionh.dk

Denmark2 sites, 2 recruiting
  • Rigshospitalet

    Copenhagen

    Sacha Stormlund, MD, sacha.stormlund.01@regionh.dk

    Recruiting
  • University Hospital Hvidovre

    Hvidovre

    Sacha Stormlund, MD, sacha.stormlund.01@regionh.dk

    Anja Pinborg, MD, DMSc, anja.bisgaard.pinborg@regionh.dk

    Recruiting

Other trials in Denmark

About this study

Official title: A Multicentre Randomized Controlled Trial of a "Freeze All and Transfer Later" Versus a Conventional "Fresh Embryo Transfer" Strategy for Assisted Reproductive Technology (ART) in Women With a Regular Menstrual Cycle

The purpose of this study is to compare conventional fresh embryo transfer with a "freeze all and transfer later strategy" in assisted reproductive technology in terms of ongoing pregnancy rates, live birth rates as well as perinatal outcomes.

Read the detailed description

The study is a multicentre randomized controlled double-blinded trial with the purpose to investigate if pregnancy- and live birth rates can be improved by a "freeze all and transfer later"-strategy with transfer of the best quality, frozen, thawed embryo in a subsequent natural cycle compared with conventional fresh embryo transfer with transfer of the embryo in the stimulated cycle.

In total 5 clinics in Denmark and Sweden will be participating in the recruitment of patients for the study.

The patients will be screened and randomized computerized on cycle day 2 or 3 and allocated to one of the two study arms:

I: hCG (human chorion gonadotrophin) arm with traditional hCG triggering and fresh blastocyst transfer II: GnRH (gonadotropin-releasing hormone)- agonist triggering arm with blastocyst cryopreservation and subsequent transfer in a subsequent natural cycle.

The randomization will be done after the decision of gonadotrophin (rFSH/hMG) starting dose, and both doctor and patient will be blinded to the randomization until the day of hCG/agonist trigger. Both groups will be stimulated in a short GnRH antagonist protocol. The ovarian stimulation The gonadotrophin stimulation is performed according to the general standards in each of the clinics and can be altered according to the ovarian response with a maximum of 300 IU.

Blood samples are collected at baseline before the first gonadotrophin injection and at day of hCG injection and further blood samples in the luteal phase will be collected for a small subgroup of patients. All blood samples will be kept at the Biobank for the study at Hvidovre Hospital.

Women in both arms will furthermore be requested to fill out a physical discomfort and a quality of life questionnaire at two different visits. Additionally the men will be asked to fill out quality of life questionnaires.

Comprehensive sonography will be performed at the start of ovulation with details on each ovary. Ultrasound examination is performed on cycle day 2-3, at stimulation day 6 and thereafter every 2-3 days until ovulation is inducted.

On the day of oocyte retrieval the randomization is unblinded. The oocytes are fertilized by either IVF or ICSI and cultured individually according to the normal procedures in the clinics.

If the patient is allocated to the "Fresh embryo transfer"-group the best quality blastocyst will be transferred on day five after oocyte pick-up, if a blastocyst is developed. Surplus good quality blastocysts are vitrified on day five or six.

For patients in the "Freeze all" group all embryos of good quality are vitrified at the blastocyst stage day 5 in the stimulated cycle according to the criteria for freezing blastocysts in each clinic. The highest quality embryo is selected and marked and will be the first one to be thawed after at least one mentrual cycle that is considered as a wash out period. Embryo transfer is performed 6-7 days after hCG injection in the blastocyst transfer cycle in this group.

A serum beta-hCG test is performed 11 days after blastocyst transfer, and clinical pregnancy is confirmed by transvaginal ultrasound 3 to 4 weeks after a positive serum-hCG test.

A follow-up of all pregnancies will be performed within three months after delivery or termination of pregnancy on predefined information sheets. All pregnancies resulting from blastocysts retrieved and thawed according to this study protocol will be followed from study inclusion and one year onwards.

All data will be collected in a single database and all participants will be anonymized by way of an identificationcode. The biobank will be closed and all samples destroyed after 5 years of the conclusion of the study at the latest.

The study is a superiority study with 424 (212 in each arm) patients required to have an 80 % chance of detecting, as significant at the 5 % level, a decrease in the primary outcome measure from 30 % in the control group to 43 % in the experimental group.

Conditions
Infertility
Being tested
Freeze all
Keywords
Assisted reproduction, In vitro fertilisation, Frozen embryo transfer (FET)
Medical subject headings
Infertility

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Freeze allProcedure or surgery

    Freezing of all blastocyst stage embryos with thawing and transfer in a subsequent natural cycle

Study groups in NCT02746562
Study groupRoleWhat they receive
Freeze allExperimentalTransfer of a frozen, thawed blastocyst in a subsequent natural menstrual cycle
Receives: Procedure: Freeze all
Fresh embryo transferNo interventionStandard procedure

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Ongoing pregnancy rates

    Outcome measured per transfer of the first blastocyst, per oocyte pick-up, per start of ovarian stimulation and per randomized patient.

    Measured: Two years

Secondary outcomes (16)
  1. Live birth rates

    Outcome measured after the first blastocyst transfer calculated per randomized patient, per started ovarian stimulation, per oocyte pick-up and per transfer

    Measured: Two years

  2. Cumulative live birth rates

    Measured after one stimulated cycle with oocyte retrieval and after use of all frozen blastocysts or after at least 1 year of follow-up

    Measured: Two years

  3. Number of cycles with no embryo transfer

    Measured: Two years

  4. Time-to-pregnancy

    From start of ovarian stimulation to positive hCG

    Measured: Two years

  5. Time-to-delivery

    Measured: Three years

  6. Preterm birth

    Measured: Three years

  7. Low birth weight

    Measured: Three years

  8. Small-for-gestational age (SGA)

    Measured: Three years

  9. Large-for-gestational age (LGA)

    Measured: Three years

  10. Perinatal mortality

    Measured: Three years

  11. Preeclampsia

    Measured: Three years

  12. Placental rupture

    Measured: Three years

  13. Positive hCG 11 days post embryo transfer

    Measured: Three years

  14. Miscarriages, biochemical pregnancies, ectopic pregnancies

    Measured: Three years

  15. Quality of life for female and partner

    Measured: Two years

  16. Cost-effectiveness

    Measured: Three years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Apr 2016 (estimated)
  2. Study startMay 2016
  3. Primary completionJan 2019
  4. Study completionSep 2019 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
424 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02746562
Sponsor's protocol ID
1600-1116
Status last verified
Apr 2019
First submitted
18 Apr 2016
Last updated
2 Apr 2019
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Pilegaard SP, Schmidt L, Stormlund S, Koert E, Bogstad JW, Praetorius L, Nielsen HS, la Cour Freiesleben N, Sopa N, Klajnbard A, Humaidan P, Bergh C, Englund ALM, Lossl K, Pinborg A. Psychosocial wellbeing shortly after allocation to a freeze-all strategy compared with a fresh transfer strategy in women and men: a sub-study of a randomized controlled trial. Hum Reprod. 2023 Nov 2;38(11):2175-2186. doi: 10.1093/humrep/dead188.

    PubMed 37742131
  • Alexopoulou E, Stormlund S, Lossl K, Praetorius L, Sopa N, Bogstad JW, Mikkelsen AL, Forman J, la Cour Freiesleben N, Vikkelso Jeppesen J, Bergh C, Al Humaidan PSH, Grondahl ML, Zedeler A, Pinborg AB. Embryo Morphokinetics and Blastocyst Development After GnRH Agonist versus hCG Triggering in Normo-ovulatory Women: a Secondary Analysis of a Multicenter Randomized Controlled Trial. Reprod Sci. 2021 Oct;28(10):2972-2981. doi: 10.1007/s43032-021-00564-9. Epub 2021 Apr 13.

    PubMed 33847977
  • Zaat T, Zagers M, Mol F, Goddijn M, van Wely M, Mastenbroek S. Fresh versus frozen embryo transfers in assisted reproduction. Cochrane Database Syst Rev. 2021 Feb 4;2(2):CD011184. doi: 10.1002/14651858.CD011184.pub3.

    PubMed 33539543
  • Stormlund S, Sopa N, Zedeler A, Bogstad J, Praetorius L, Nielsen HS, Kitlinski ML, Skouby SO, Mikkelsen AL, Spangmose AL, Jeppesen JV, Khatibi A, la Cour Freiesleben N, Ziebe S, Polyzos NP, Bergh C, Humaidan P, Andersen AN, Lossl K, Pinborg A. Freeze-all versus fresh blastocyst transfer strategy during in vitro fertilisation in women with regular menstrual cycles: multicentre randomised controlled trial. BMJ. 2020 Aug 5;370:m2519. doi: 10.1136/bmj.m2519.

    PubMed 32759285
  • Stormlund S, Lossl K, Zedeler A, Bogstad J, Praetorius L, Nielsen HS, Bungum M, Skouby SO, Mikkelsen AL, Andersen AN, Bergh C, Humaidan P, Pinborg A. Comparison of a 'freeze-all' strategy including GnRH agonist trigger versus a 'fresh transfer' strategy including hCG trigger in assisted reproductive technology (ART): a study protocol for a randomised controlled trial. BMJ Open. 2017 Jul 31;7(7):e016106. doi: 10.1136/bmjopen-2017-016106.

    PubMed 28760794

Questions about this trial

What is this clinical trial studying?

A study testing Freeze all in people with Infertility, run by Anja Bisgaard Pinborg at 2 sites in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 2 Apr 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Sacha Stormlund, MD (sacha.stormlund.01@regionh.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Ongoing pregnancy rates (time frame: Two years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02746562, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Apr 2019; AzTrials last refreshed its copy on 29 Oct 2026.

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