Treatment of Infertility in Women With Polycystic Ovary Syndrome - Full Text View

Purpose

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting up to 10% of women. The primary symptoms of PCOS are menstrual irregularities, increased body and facial hair, acne, and infertility. This study will test a combination of medications in women with PCOS to determine which works best to overcome infertility.

Condition	Intervention	Phase
Polycystic Ovary Syndrome Infertility Pregnancy	Drug: metformin XR Drug: clomiphene citrate	Phase III

MedlinePlus related topics:

Infertility

Drug Information available for:

Metformin Metformin hydrochloride Citric acid Sodium Citrate Clomiphene citrate Clomiphene Enclomiphene Zuclomiphene

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Randomized, Double-Blind, Active Control, Factorial Assignment, Safety/Efficacy Study

Official Title:	Pregnancy in Polycystic Ovary Syndrome: A 30 Week Double-Blind Randomized Trial of Clomiphene Citrate, Metformin XR, and Combined Clomiphene Citrate/Metformin XR For the Treatment of Infertility in Women With Polycystic Ovary Syndrome

Further study details as provided by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD):

Primary Outcome Measures:

Live birth rate

Secondary Outcome Measures:

singleton live birth rate
ovulation rate
cycles to first ovulation
cycles to conception
abortion rate
cycles to pregnancy
weeks from pregnancy to live birth

Estimated Enrollment:	678
Study Start Date:	November 2002
Study Completion Date:	February 2006

Detailed Description:

PCOS is characterized by excess circulating androgen levels and chronic anovulation. The fundamental pathophysiologic defect is unknown, but PCOS is characterized by insulin resistance and compensatory hyperinsulinemia. Improvements in insulin sensitivity in PCOS women, either through lifestyle changes or through pharmaceutical intervention, have consistently resulted in a marked improvement in the reproductive and metabolic abnormalities in PCOS. Resumption of ovulation occurs in up to 70% of women treated for PCOS. This study will evaluate the safety and effectiveness of clomiphene citrate and metformin XR in achieving a successful pregnancy in infertile PCOS women.

Women with PCOS who are seeking pregnancy will be enrolled in this study. Women will be randomized to one of three different treatment arms: A) metformin XR 1000 mg twice/day; B) clomiphene citrate 50 mg every day for 5 days (day 3-7 of cycle); or C) metformin XR 1000 mg twice/day with clomiphene citrate 50 mg/day for 5 days (day 3-7 of cycle). Women will continue on study medications for 30 weeks, 6 treatment cycles, or until they become pregnant. Progesterone levels will be drawn weekly to monitor ovulation.

Eligibility

Ages Eligible for Study:	18 Years to 39 Years
Genders Eligible for Study:	Female
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria

Eight or fewer menstrual cycles in the past year or intermenstrual periods of 45 days or longer
Elevated testosterone level
Good general health
Sperm concentration in partner of 20 million/ml or greater
Ability to have intercourse 2-3 times per week
One functional fallopian tube and normal uterine cavity

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00068861

Locations


United States, Alabama
	University of Alabama at Birmingham
	Birmingham, Alabama, United States, 35249

United States, California
	Stanford University
	Stanford, California, United States, 94305
	University of California at San Diego
	La Jolla, California, United States, 92037

United States, Colorado
	University of Colorado
	Aurora, Colorado, United States, 80045

United States, Michigan
	Wayne State
	Detroit, Michigan, United States, 48201

United States, New Jersey
	University of Medicine and Dentistry New Jersey
	Newark, New Jersey, United States, 07103

United States, Pennsylvania
	University of Pennsylvania
	Philadelphia, Pennsylvania, United States, 19104
	Penn State
	Hershey, Pennsylvania, United States, 17033

United States, Texas
	Baylor College of Medicine
	Houston, Texas, United States, 77030
	University of Texas Southwestern Medical Center
	Dallas, Texas, United States, 75390

United States, Virginia
	Virginia Commonwealth University
	Richmond, Virginia, United States, 23298

Sponsors and Collaborators

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

More Information

Publications:

Myers ER, Silva SG, Hafley G, Kunselman AR, Nestler JE, Legro RS; National Institute of Child Health and Human Development Reproductive Medicine Network. Estimating live birth rates after ovulation induction in polycystic ovary syndrome: sample size calculations for the pregnancy in polycystic ovary syndrome trial. Contemp Clin Trials. 2005 Jun;26(3):271-80.

Publications indexed to this study:

Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP, Carson SA, Steinkampf MP, Coutifaris C, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Giudice LC, Ewens KG, Spielman RS, Leppert PC, Myers ER; Reproductive Medicine Network. Ovulatory response to treatment of polycystic ovary syndrome is associated with a polymorphism in the STK11 gene. J Clin Endocrinol Metab. 2008 Mar;93(3):792-800. Epub 2007 Nov 13.

Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP, Carson SA, Steinkampf MP, Coutifaris C, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Giudice LC, Leppert PC, Myers ER; Cooperative Multicenter Reproductive Medicine Network. Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. N Engl J Med. 2007 Feb 8;356(6):551-66.

Study ID Numbers:	NICHD-PPCOS
First Received:	September 10, 2003
Last Updated:	September 28, 2007
ClinicalTrials.gov Identifier:	NCT00068861
Health Authority:	United States: Food and Drug Administration

Study placed in the following topic categories:

Infertility

Gonadal Disorders

Metformin

Citric Acid

Endocrine System Diseases

Clomiphene

Ovarian Diseases

Genital Diseases, Male

Cysts

Genital Diseases, Female

Polycystic Ovary Syndrome

Endocrinopathy

Ovarian Cysts

Additional relevant MeSH terms:

Estrogen Antagonists

Disease

Hormone Antagonists

Physiological Effects of Drugs

Hormones, Hormone Substitutes, and Hormone Antagonists

Reproductive Control Agents

Selective Estrogen Receptor Modulators

Pharmacologic Actions

Adnexal Diseases

Estrogen Receptor Modulators

Neoplasms

Hypoglycemic Agents

Pathologic Processes

Therapeutic Uses

Syndrome

Fertility Agents, Female

Fertility Agents

ClinicalTrials.gov processed this record on November 20, 2008

Sponsored by:	Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Information provided by:	Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
ClinicalTrials.gov Identifier:	NCT00068861