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Effect of Colony Stimulating Factor on Poor Endometrial Development During IVF
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Purpose
| Condition | Intervention | Phase |
|---|---|---|
| Infertility, Female | Drug: G-CSF Drug: Saline | Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Crossover Assignment Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | G-CSF and Endometrial Growth, Embryo Implantation and Pregnancy Following FET or Donor ET |
- Endometrial Thickness [ Time Frame: Day of embryo transfer ]Thickness of the endometrium on the day of embryo transfer
- Implantation Rate [ Time Frame: 28 days after embryo transfer ]Number of gestational sacs per number of embryos transferred in each treatment group
| Enrollment: | 12 |
| Study Start Date: | September 2010 |
| Study Completion Date: | February 2013 |
| Primary Completion Date: | February 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: G-CSF
G-CSF 300 units administered by trans-cervical infusion one time on day of hCG trigger for Ovulation
|
Drug: G-CSF
One infusion of G-CSF 300 units administered by intrauterine infusion
Other Name: NEUPOGEN (Filgrastim)
|
|
Placebo Comparator: Saline
Saline administered by trans-cervical infusion one time on day of hCG trigger for ovulation
|
Drug: Saline
One intrauterine saline infusions of 1 cc
Other Names:
|
Detailed Description:
Objective: To investigate the effect of treatment with CSF : A placebo controlled double blinded crossover study.
Design: Crossover Randomized Control Trial
Setting: Academically affiliated private infertility centers
Subjects: Female IVF patients of all ages who are willing to be randomized to treatment and, in either IVF treatment, frozen embryo cycles (FET) or donor IVF cycles (D-IVF), 5 days before ET, have inadequate endometrial thickness.
Interventions: Subjects receive transvaginally, utilizing an insemination catheter, 2 slow intrauterine lavages with CSF-1 (Neupogen or generic, 300ug in 1 ml) 5 and 3 days, respectively, before embryo transfer and controls receive 1 ml of saline instead. Patients who do not become pregnant will after one month washout times continue treatment in the opposite study arm if they so choose and if they have remaining embryos.
Main Outcome Measures: Number of patients reaching embryo transfer with adequate endometrial thickness of at least 7mm.
Second Outcome Measures: Implantation and pregnancy rates..
Statistical and Power considerations: This is a Randomized Controlled Trial (RCT) with two study arms and panned crossover. Patients will be randomly assigned to Study group A or B according to a computer generated randomization table with 50:50 distributions. The study will test the null hypothesis that there is no difference in the transfer rates between the two groups. Transfer is only possible if the endometrial thickness reaches 7 mm or more. Order of treatment ab v ba will be added to the models as a separate factor and each phase will be analyzed as separate treatment strata.
The investigators are planning a study of independent cases and controls with 1 control per case. Prior data indicate that the transfer rate among controls is < 1%. If the true transfer rate for experimental subjects is 25%, the investigators will need to study 38 experimental subjects and 38 control subjects to be able to reject the null hypothesis that the transfer rates for experimental and control subjects are equal with probability (power) 0.8. The Type I error probability associated with this test of this null hypothesis is 0.05. We will use a continuity-corrected chi-squared statistic or Fisher's exact test to evaluate this null hypothesis.
There will be a planned interim analysis after 20 participants have completed the trial and if significant effects are observed the trial may be terminated at that time. The power to detect a difference in this interim analysis is only 42.6%.
Eligibility| Ages Eligible for Study: | 21 Years to 45 Years (Adult) |
| Sexes Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Patient's preparing for invitro fertilization and embryo transfer with endometrial growth of less than 7 mm, unresponsive to standard treatment
Exclusion Criteria:
- Sickle Cell disease
- Renal insufficiency
- Upper respiratory infection or Pneumonia
- Chronic Neutropenia
- Known Past or present malignancy
Contacts and LocationsPlease refer to this study by its ClinicalTrials.gov identifier: NCT01202643
| United States, New York | |
| Center for Human Reproduction | |
| New York, New York, United States, 10021 | |
| Principal Investigator: | David H Barad, MD, MS | Center for Human Reproduction |
| Study Chair: | Norbert Gleicher, MD | Center for Human Reproduction |
More Information
| Responsible Party: | David H. Barad, Director of Clinical Research, Center for Human Reproduction |
| ClinicalTrials.gov Identifier: | NCT01202643 History of Changes |
| Other Study ID Numbers: |
09012010-01 |
| Study First Received: | September 14, 2010 |
| Results First Received: | May 18, 2014 |
| Last Updated: | November 25, 2014 |
Keywords provided by David H. Barad, Center for Human Reproduction:
|
Thin Endometrium Asherman's Syndrome Endometrial Scarring |
Additional relevant MeSH terms:
|
Infertility Infertility, Female Genital Diseases, Male Genital Diseases, Female |
Lenograstim Adjuvants, Immunologic Immunologic Factors Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on August 18, 2017