Use of High Cost Monitoring During Letrozole Ovulation Induction
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Purpose
The purpose of this study is to investigate monitoring methods during ovulation induction cycles with letrozole and their effect on pregnancy rates. Monitoring ovulation induction cycles with letrozole can be done with a variety of methods, the two most commonly utilized are home-based urinary LH kits (or ovulation predictor kits) and office-based midcycle follicular ultrasound. Letrozole coupled with follicular monitoring by ultrasound may add extra cost per cycle with no improvement in fecundability (pregnancy rates per cycle).
| Condition | Intervention | Phase |
|---|---|---|
|
Infertility |
Other: Midcycle ultrasound + hCG injection Other: Urinary LH kits |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Use of High Cost Monitoring During Letrozole Ovulation Induction and Effect on Pregnancy Rates |
- Pregnancy rate per cycle [ Time Frame: 4 treatment cycles or upon conception ] [ Designated as safety issue: No ]
- Cost per conception [ Time Frame: 4 cycles or upon conception ] [ Designated as safety issue: No ]
- Time to conception [ Time Frame: 4 cycles or upon conception ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 400 |
| Study Start Date: | January 2011 |
| Estimated Study Completion Date: | July 2013 |
| Estimated Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Group A
Patients randomized to this arm will monitor ovulation with home-based urinary LH kits (Ovulation Predictor Kits, OPK's).
|
Other: Urinary LH kits
Subjects randomized to monitoring with LH kits at home will keep a monthly calendar documenting when LH testing begins, day LH surge occurs and day(s) of intercourse/insemination.
Other Name: ClearBlue Easy
|
|
Active Comparator: Group B
Patients randomized to this arm will undergo ovulation monitoring with midcycle ultrasound and receive hCG injection if evidence of a mature size follicle.
|
Other: Midcycle ultrasound + hCG injection
Mid-cycle ultrasound with administration of hCG (single dose of standardized pre-filled injection, 250 mcg, at time of ultrasound) when appropriate.
Other Name: Ovidrel
|
Detailed Description:
The study will be a randomized controlled trial of adult women with primary and secondary infertility seen at the University of Michigan Health System undergoing ovulation induction (OI) with letrozole as part of their standard clinical care. Patients who are undergoing OI with letrozole as per standard clinical care will be randomized to urinary luteinizing hormone (LH) ovulation predictor kit use versus mid-cycle ultrasound with administration of hCG when appropriate for timing of intercourse or intrauterine insemination. Patients who have been prescribed letrozole as per routine clinical care will be approached to determine willingness to participate in this study. Study period involves up to four ovulation induction cycles or until pregnancy occurs.
Eligibility| Ages Eligible for Study: | 21 Years to 39 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Women ages 21-39 undergoing letrozole ovulation induction (as part of routine clinical care) at a single academic-infertility center.
- Normal uterus and evidence of at least tubal patency on one side (as assessed by saline-infusion sonography or hysterosalpingogram per clinical care).
Exclusion Criteria:
- Current pregnancy
- Nursing mothers
- Prior hypersensitivity to hCG preparations
- Primary ovarian failure or menopausal levels of FSH (>12 mIU/mL)
- Patients with abnormal uterine bleeding of undetermined origin or ovarian cyst of undetermined origin, sex-hormone dependent tumors, documented bilateral tubal obstruction, uncorrected uterine anomalies,
- Previous letrozole or gonadotropin use and/or previous treatment with in vitro fertilization
- Other uncorrected medical condition that would be a contraindication to attempting elective ovulation induction (e.g., uncontrolled diabetes, intracranial lesion, thyroid or adrenal disease).
Contacts and Locations| United States, Michigan | |
| Center for Reproductive Medicine, University of Michigan | |
| Ann Arbor, Michigan, United States, 48108 | |
| Principal Investigator: | Senait Fisseha, MD, JD | University of Michigan |
More Information
Publications:
| Responsible Party: | Senait Fisseha, MD, JD, University of Michigan |
| ClinicalTrials.gov Identifier: | NCT01279200 History of Changes |
| Other Study ID Numbers: | HUM00041349, 1726.PIRAP |
| Study First Received: | January 18, 2011 |
| Last Updated: | January 18, 2011 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of Michigan Health System:
|
letrozole ovulation monitoring pregnancy rate |
Additional relevant MeSH terms:
|
Infertility Genital Diseases, Male Genital Diseases, Female Letrozole Antineoplastic Agents |
Therapeutic Uses Pharmacologic Actions Aromatase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 19, 2013