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InfertilityNCT04142190

Corifollitropin Alfa and Embryo Morphokinetics

An observational study of Infertility, run by Kinderwunsch Institut GmbH at 1 site in Austria.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The study evaluates the influence of corifollitropin alfa (Elonva) on embryo morphokinetics and fertility treatment outcome in comparison to a control group stimulated with Follitropin beta (Puregon). Read more about this study

Who is it for?
Ages 18 to 42 years, women only
Conditions the study is for
Infertility
What is being tested?
ELONVA and PUREGON
Type of treatment
Injection or infusion
How many people
1,351 participants
Where
1 siteAustria
Study dates
Jan 2013to Dec 2018
Phase
Observational
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 42 years
  • Women only
  • Adult

Study population: Women suffering from infertility

Who may be able to join

  • Age: 18-42
  • BMI: 19-29.9
  • Primary or secondary infertility
  • Ovarian stimulation with Elonva/Puregon
  • Embryos cultured in embryoscope

Who cannot join

  • unexpected low response
  • genetic testing

Trial locations and contacts

1 site in 1 country.

Austria1 site
  • Das Kinderwunsch Institut Schenk GmbH

    Dobl, Styria, 8143

Other trials in Austria

About this study

Official title: Influence of Corifollitropin Alfa (Elonva) on Embryo Morphokinetics and Fertility Treatment Outcome

The study evaluates the influence of corifollitropin alfa (Elonva) on embryo morphokinetics and fertility treatment outcome in comparison to a control group stimulated with Follitropin beta (Puregon).

Read the detailed description

Morphokinetic parameters of embryo development have been intensively investigated. However, little attention has been paid to the influence of ovarian stimulation on morphokinetic parameters. Gryshenko et al. found a significant difference in the fourth cell division time (t5) of embryos obtained after controlled ovarian hyperstimulation in long GnRH agonists and GnRH antagonist protocols. Furthermore, higher gonadotropin doses were found to slow down the development of the embryos.

Hence, the aim of this study is to investigate the influence of corifollitropin alfa (Elonva) on embryo morphokinetics and fertility treatment outcome in comparison to a control group stimulated with Follitropin beta (Puregon). The investigators hypothesize that there are differences in morphokinetic behavior of embryos within the different stimulation protocols.

A total of 742 embryos from 215 different patients suffering from infertility undergoing ovarian stimulation with Elonva and a total of 5148 embryos from 1136 patients undergoing ovarian stimulation with Puregon will be retrospectively analyzed. To exclude environmental factors the evaluation will distinguish between embryos cultured under 21% oxygen and embryos with reduced oxygen conditions (5% oxygen) in the embryoscope. Groups will be age and BMI matched.

All women included in the study underwent GnRH (Gonadotropin-releasing hormone) antagonist protocol controlled ovarian hyperstimulation. Patients received recombinant human follicle-stimulating hormone (Elonva; MSD Sharp \&Dohme GMBH, Puregon; MSD Sharp \& Dohme GMBH). ELONVA was administered for 7 days with subsequent administration of Puregon (MSD Sharp \& Dohme GMBH) in case of further need of stimulation. Puregon was administered for 8-10 days with dosage adaption according to age, weight, serum anti-mullerian hormone (sAMH) concentration, and hormonal status. Trans-vaginal sonography was performed after 5 days of stimulation, followed by every second day until the day of oocyte retrieval. Ultrasonographical measurement was performed using a RIC 5-9-D 4D intravaginal probe of a GE Voluson E8 BT09 ultrasound machine (both from GE Healthcare Austria GmbH). GnRH antagonist (Cetrotide, Merck KGaA) was injected to avoid premature ovulation. Triggering was initiated 35 h before oocyte retrieval, administered with 5000-10,000 IU human chorionic gonadotropin (hCG) subcutaneously (Pregnyl, N.V. Organon), with dosage adaption according to body weight of the patient.

Follicles larger than 10 mm in diameter were aspirated under sedation (Propofol, Fresenius Kabi Austria GmbH; Rapifen, Janssen-Cilag Pharma GmbH) and transvaginal ultrasound guidance (GE Healthcare Austria GmbH). Follicular fluid (FF) were examined for oocytes under constant conditions of 37 °C in an IVF workstation L24E with heating stage (K-SYSTEMS Kivex Biotec A/S). Intracytoplasmic sperm injection (ICSI) was performed on all metaphase II (MII) oocytes 4-5h after oocyte retrieval according to our standard operating procedure in both groups of patients.

After oocyte retrieval and fertilization, oocytes were cultivated in universal culture medium (Gynemed Medizinprodukte GmbH \& Co. KG, Germany). After 14-16 h, fertilization check was performed. All normal fertilized embryos with two pronuclei (PN) were then cultured using Embryoslide dishes in Embryoscope® time-lapse incubator (both Vitrolife AB, Sweden). With the built-in camera and microscope, images of the developing embryo were taken every 15 min in seven different layers. Definition of morphokinetic parameters was performed according to the criteria proposed by Ciray et al. and was analyzed with software developed for time-lapse image analysis (Embryoviewer® software; Vitrolife AB, Sweden).

Conditions
Infertility
Being tested
ELONVA, PUREGON
Keywords
follicle-stimulating hormone, embryo morphokinetics, reproductive medicine
Medical subject headings
Infertility

What participants receive

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

  • ELONVADrug

    Elonva is a solution for injection that contains the active substance corifollitropin alfa. It is available as a pre-filled syringe (100 and 150 micrograms).Elonva is used in women who are undergoing fertility treatment to stimulate the development of more than one mature egg at a time in the ovaries.

  • PUREGONDrug

    Puregon contains the active substance follitropin beta. fertilisation). Puregon is administered to stimulate the ovaries to produce more than one egg at a time

Study groups in NCT04142190
Study groupRoleWhat they receive
ELONVAPatients stimulated with Elonva
Receives: Drug: ELONVA
PUREGONPatients stimulated with Puregon
Receives: Drug: PUREGON

What is being measured

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

  1. Time of pronuclei disappearance

    Time of pronuclei disappearance in embryos of patients stimulated with ELONVA versus embryos of patients stimulated with PUREGON

    Measured: 16-18 hours after fertilization

  2. Two discrete cells

    The first observation of two discrete cells in embryos of patients stimulated with ELONVA versus embryos of patients stimulated with PUREGON

    Measured: 26-28 hours after fertilization

  3. Three discrete cells

    The first observation of three discrete cells in embryos of patients stimulated with ELONVA versus embryos of patients stimulated with PUREGON

    Measured: 28-44 hours after fertilization

  4. Four discrete cells

    The first observation of four discrete cells in embryos of patients stimulated with ELONVA versus embryos of patients stimulated with PUREGON

    Measured: 44-45 hours after fertilization

  5. Five discrete cells

    The first observation of five discrete cells in embryos of patients stimulated with ELONVA versus embryos of patients stimulated with PUREGON

    Measured: 44-68 hours after fertilization

  6. Six discrete cells

    The first observation of six discrete cells in embryos of patients stimulated with ELONVA versus embryos of patients stimulated with PUREGON

    Measured: 44-68 hours after fertilization

  7. Seven discrete cells

    The first observation of seven discrete cells in embryos of patients stimulated with ELONVA versus embryos of patients stimulated with PUREGON

    Measured: 44-68 hours after fertilization

  8. Eight discrete cells

    The first observation of eight discrete cells in embryos of patients stimulated with ELONVA versus embryos of patients stimulated with PUREGON

    Measured: 68-69 hours after fertilization

  9. Nine discrete cells

    The first observation of nine discrete cells in embryos of patients stimulated with ELONVA versus embryos of patients stimulated with PUREGON

    Measured: 69-92 hours after fertilization

  10. Morula stage

    End of the compaction process; when observable compaction is complete in embryos of patients stimulated with ELONVA versus embryos of patients stimulated with PUREGON

    Measured: 92 hours after fertilization

Secondary outcomes (8)
  1. Number of oocytes retrieved

    The influence of ELONVA versus PUREGON on the number of oocytes retrieved will be assessed.

    Measured: Number of oocytes retrieved will be evaluated after one treatment cycle (each cycle is between 28 and 35 days)

  2. Stage of oocyte development

    The influence of ELONVA versus PUREGON on the maturity stage of oocytes (germinal vesicle, metaphase I (MI) or MII phase) retrieved will be assessed.

    Measured: Stage of oocytes retrieved will be evaluated after one treatment cycle (each cycle is between 28 and 35 days)

  3. Fertilized oocytes

    The influence of ELONVA versus PUREGON on the number of fertilized oocytes will be assessed.

    Measured: Number of fertilized oocytes will be evaluated after one treatment cycle (each cycle is between 28 and 35 days)

  4. Embryo grading

    The influence of ELONVA versus PUREGON on embryo grading (Istanbul consensus criteria) will be assessed. The grading consists of assessment of cell number, fragmentation, multinucleation, cell size, cytoplasmic granularity, membrane appearance, and the presence of vacuoles).

    Measured: The quality of embryos will be evaluated after one treatment cycle (each cycle is between 28 and 35 days)

  5. Biochemical pregnancy (measurement of beta hCG)

    The influence of Elonva versus Puregon on the number of biochemical pregnancies will be assessed.

    Measured: Biochemical pregnancies will be evaluated after successful implantation (1 week after embryo transfer)

  6. Life birth

    The influence of Elonva versus Puregon on the number of life births will be assessed.

    Measured: Life births will be evaluated after successful pregnancy (9 moths after embryo transfer)

  7. Weight (kilograms)

    The influence of Elonva versus Puregon on the weight of the newborn will be assessed.

    Measured: Weight of the newborn will be evaluated after birth (9 moths after embryo transfer)

  8. Height (centimeters)

    The influence of Elonva versus Puregon on the height of the newborn will be assessed.

    Measured: Height of the newborn will be evaluated after birth (9 moths after embryo transfer)

Timeline

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

  1. First posted29 Oct 2019
  2. Study startJan 2013
  3. Primary completionDec 2018
  4. Study completionDec 2018

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Retrospective
Enrolment
1,351 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04142190
Sponsor's protocol ID
FRED001
Status last verified
Oct 2019
First submitted
14 Oct 2019
Last updated
29 Oct 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided: It has to be clarified with MERCK if sharing of data is applicable for this project.

Publications

  • Gryshchenko MG, Pravdyuk AI, Parashchyuk VY. Analysis of factors influencing morphokinetic characteristics of embryos in ART cycles. Gynecol Endocrinol. 2014 Oct;30 Suppl 1:6-8. doi: 10.3109/09513590.2014.945763.

    PubMed 25200818
  • Wissing ML, Bjerge MR, Olesen AI, Hoest T, Mikkelsen AL. Impact of PCOS on early embryo cleavage kinetics. Reprod Biomed Online. 2014 Apr;28(4):508-14. doi: 10.1016/j.rbmo.2013.11.017. Epub 2013 Dec 17.

    PubMed 24581983
  • Chawla M, Fakih M, Shunnar A, Bayram A, Hellani A, Perumal V, Divakaran J, Budak E. Morphokinetic analysis of cleavage stage embryos and its relationship to aneuploidy in a retrospective time-lapse imaging study. J Assist Reprod Genet. 2015 Jan;32(1):69-75. doi: 10.1007/s10815-014-0372-3. Epub 2014 Nov 14.

    PubMed 25395178
  • Armstrong S, Vail A, Mastenbroek S, Jordan V, Farquhar C. Time-lapse in the IVF-lab: how should we assess potential benefit? Hum Reprod. 2015 Jan;30(1):3-8. doi: 10.1093/humrep/deu250. Epub 2014 Oct 14.

    PubMed 25316446
  • Milewski R, Kuc P, Kuczynska A, Stankiewicz B, Lukaszuk K, Kuczynski W. A predictive model for blastocyst formation based on morphokinetic parameters in time-lapse monitoring of embryo development. J Assist Reprod Genet. 2015 Apr;32(4):571-9. doi: 10.1007/s10815-015-0440-3. Epub 2015 Feb 18.

    PubMed 25690157
  • VerMilyea MD, Tan L, Anthony JT, Conaghan J, Ivani K, Gvakharia M, Boostanfar R, Baker VL, Suraj V, Chen AA, Mainigi M, Coutifaris C, Shen S. Computer-automated time-lapse analysis results correlate with embryo implantation and clinical pregnancy: a blinded, multi-centre study. Reprod Biomed Online. 2014 Dec;29(6):729-36. doi: 10.1016/j.rbmo.2014.09.005. Epub 2014 Sep 21.

    PubMed 25444507

Questions about this trial

What is this clinical trial studying?

An observational study of Infertility, run by Kinderwunsch Institut GmbH at 1 site in Austria.

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 5 inclusion and 2 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: finished, as of the sponsor's last update on 29 Oct 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Austria. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time of pronuclei disappearance (time frame: 16-18 hours after fertilization). The study lists 10 primary outcomes in all. 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 NCT04142190, which also lists 6 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 29 Oct 2019.

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Corifollitropin Alfa and Embryo Morphokinetics | AzTrials