Investigation of a Long-Acting Follicle Stimulating Hormone in Infertile Women Undergoing Assisted Reproductive Technology (ART)

Sponsor
Merck KGaA, Darmstadt, Germany (Industry)
Overall Status
Completed
CT.gov ID
NCT00505752
Collaborator
(none)
520
1
4
20
26

Study Details

Study Description

Brief Summary

This is a Phase 2, interventional, prospective, multi-center, randomized, assessor-blind, active-comparator, dose-finding study to evaluate a new investigational long-acting follicle stimulating hormone (FSH) in infertile women who are undergoing an assisted reproductive technology (ART) procedure (In vitro fertilization/Intra cytoplasmic sperm injection [IVF/ICSI]). This study will compare 3 doses of the investigational drug versus a currently marketed drug follitropin alfa (Gonal-f® revised formulation female [RFF] Pen) in regards to the number of fertilized oocytes.

Condition or Disease Intervention/Treatment Phase
  • Drug: AS900672-Enriched 50 microgram (mcg)
  • Drug: AS900672-Enriched 100 mcg
  • Drug: AS900672-Enriched 150 mcg
  • Drug: Follitropin alfa 150 international unit (IU)
  • Drug: Recombinant human chorionic gonadotropin (r-hCG)
Phase 2

Detailed Description

Infertile women who are candidates for ART will be prospectively screened for enrollment at 24 clinical trial sites in the United States and Argentina. Enrolled subjects will start treatment using oral contraceptives (OCP) and will then receive a Gonadotropin releasing hormone (GnRH)-agonist (leuprolide acetate) for pituitary desensitization. Once down-regulation is achieved, the subjects will be randomized in a 1:1:1:1 ratio to begin ovarian stimulation with one of 3 doses of AS900672-Enriched or with follitropin alfa (Gonal-f®) daily injections. Subjects will be recruited to the four study arms in parallel. Beginning on S1, the subjects will receive either a single injection of AS900672-Enriched or start daily injections of follitropin alfa. The subjects' response to treatment will be monitored by ovarian ultrasound and E2 levels. On S6, subjects randomized to AS900672-Enriched may begin receiving supplemental follitropin alfa 150 IU, according to the each subject's ovarian response, and subjects randomized to follitropin alfa 150 IU daily injections will continue treatment at the same dose. Recombinant human chorionic gonadotropin (r-hCG, Ovidrel®) will be administered to subjects meeting response criteria and who are not at risk for ovarian hyperstimulation syndrome (OHSS). Oocyte retrieval will occur within 34-38 hours after r-hCG administration and subjects will begin luteal phase support using vaginal progesterone (Crinone® 8 percent or Prochieve® 8 percent) the following day. Fertilization will be done by conventional IVF or ICSI. Embryo transfer will occur in accordance with the specific requirements of each subject and the clinical trial site's standard practice, with the exception that a maximum of two embryos at the cleavage or blastocyst stage may be transferred. Subjects who undergo embryo transfer will be assessed for pregnancy and a follow-up visit will be performed 15-20 days post r-hCG administration. Subjects with a positive pregnancy test will undergo a confirmatory ultrasound evaluation at Day 35 - 42 post r-hCG. Additionally, all subjects recruited at certain trial centers will participate in a pharmacokinetic (PK) sub-study.

Study Design

Study Type:
Interventional
Actual Enrollment :
520 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Single (Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
A Phase II, Multicenter, Randomized, Assessor-blinded, Active-comparator, Dose-finding Study to Evaluate AS900672 Enriched Versus Follitropin Alfa (Gonal-f®) in Stimulating Multiple Follicular Development in Infertile Women Undergoing Assisted Reproductive Technology (ART)
Study Start Date :
Jan 1, 2007
Actual Primary Completion Date :
Sep 1, 2008
Actual Study Completion Date :
Sep 1, 2008

Arms and Interventions

Arm Intervention/Treatment
Experimental: AS900672-Enriched 50 mcg

Drug: AS900672-Enriched 50 microgram (mcg)
Single injection of AS900672-Enriched (hyperglycosylated recombinant human follicle stimulating hormone [r-hFSH]), 50 mcg will be administered subcutaneously on Stimulation Day 1 (S1). Duration of treatment cycle will be up to adequate follicular response or maximum of 21 days.
Other Names:
  • Hyperglycosylated r-hFSH
  • Drug: Follitropin alfa 150 international unit (IU)
    Follitropin alfa (Gonal-f®) 150 IU will be administered subcutaneously once daily from S1 up to Stimulation Day 21 (S21) based upon ovarian response, until recombinant human chorionic gonadotropin (r-hCG) administration day. Subjects who will be receiving AS900672-Enriched 50, 100 and 150 mcg will also receive daily dose of follitropin alfa 150 IU subcutaneously from Stimulation Day 6 (S6) up to S21. Duration of treatment cycle will be up to adequate follicular response or maximum of 21 days.
    Other Names:
  • Gonal-f®
  • Follicle stimulating hormone (FSH)
  • Drug: Recombinant human chorionic gonadotropin (r-hCG)
    Recombinant human chorionic gonadotropin (r-hCG) will be administered as a single dose of 250 mcg subcutaneously, when follicular response is adequate (that is, at least 1 follicle with a diameter of greater than or equal to [>=] 18 millimeter [mm], two or more additional follicles with a diameter of >= 16 mm, and Estradiol [E2] levels will approximately 150 picogram per milliliter [pg/mL] per mature follicle).
    Other Names:
  • Ovidrel®
  • Choriogonadotropin alfa
  • Experimental: AS900672-Enriched 100 mcg

    Drug: AS900672-Enriched 100 mcg
    Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 100 mcg will be administered subcutaneously on S1. Duration of treatment cycle will up to adequate follicular response or maximum of 21 days.
    Other Names:
  • Hyperglycosylated r-hFSH
  • Drug: Follitropin alfa 150 international unit (IU)
    Follitropin alfa (Gonal-f®) 150 IU will be administered subcutaneously once daily from S1 up to Stimulation Day 21 (S21) based upon ovarian response, until recombinant human chorionic gonadotropin (r-hCG) administration day. Subjects who will be receiving AS900672-Enriched 50, 100 and 150 mcg will also receive daily dose of follitropin alfa 150 IU subcutaneously from Stimulation Day 6 (S6) up to S21. Duration of treatment cycle will be up to adequate follicular response or maximum of 21 days.
    Other Names:
  • Gonal-f®
  • Follicle stimulating hormone (FSH)
  • Drug: Recombinant human chorionic gonadotropin (r-hCG)
    Recombinant human chorionic gonadotropin (r-hCG) will be administered as a single dose of 250 mcg subcutaneously, when follicular response is adequate (that is, at least 1 follicle with a diameter of greater than or equal to [>=] 18 millimeter [mm], two or more additional follicles with a diameter of >= 16 mm, and Estradiol [E2] levels will approximately 150 picogram per milliliter [pg/mL] per mature follicle).
    Other Names:
  • Ovidrel®
  • Choriogonadotropin alfa
  • Experimental: AS900672-Enriched 150 mcg

    Drug: AS900672-Enriched 150 mcg
    Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 150 mcg will be administered subcutaneously on S1. Duration of treatment cycle will up to adequate follicular response or maximum of 21 days.
    Other Names:
  • Hyperglycosylated r-hFSH
  • Drug: Follitropin alfa 150 international unit (IU)
    Follitropin alfa (Gonal-f®) 150 IU will be administered subcutaneously once daily from S1 up to Stimulation Day 21 (S21) based upon ovarian response, until recombinant human chorionic gonadotropin (r-hCG) administration day. Subjects who will be receiving AS900672-Enriched 50, 100 and 150 mcg will also receive daily dose of follitropin alfa 150 IU subcutaneously from Stimulation Day 6 (S6) up to S21. Duration of treatment cycle will be up to adequate follicular response or maximum of 21 days.
    Other Names:
  • Gonal-f®
  • Follicle stimulating hormone (FSH)
  • Drug: Recombinant human chorionic gonadotropin (r-hCG)
    Recombinant human chorionic gonadotropin (r-hCG) will be administered as a single dose of 250 mcg subcutaneously, when follicular response is adequate (that is, at least 1 follicle with a diameter of greater than or equal to [>=] 18 millimeter [mm], two or more additional follicles with a diameter of >= 16 mm, and Estradiol [E2] levels will approximately 150 picogram per milliliter [pg/mL] per mature follicle).
    Other Names:
  • Ovidrel®
  • Choriogonadotropin alfa
  • Active Comparator: Follitropin alfa 150 IU

    Drug: Follitropin alfa 150 international unit (IU)
    Follitropin alfa (Gonal-f®) 150 IU will be administered subcutaneously once daily from S1 up to Stimulation Day 21 (S21) based upon ovarian response, until recombinant human chorionic gonadotropin (r-hCG) administration day. Subjects who will be receiving AS900672-Enriched 50, 100 and 150 mcg will also receive daily dose of follitropin alfa 150 IU subcutaneously from Stimulation Day 6 (S6) up to S21. Duration of treatment cycle will be up to adequate follicular response or maximum of 21 days.
    Other Names:
  • Gonal-f®
  • Follicle stimulating hormone (FSH)
  • Drug: Recombinant human chorionic gonadotropin (r-hCG)
    Recombinant human chorionic gonadotropin (r-hCG) will be administered as a single dose of 250 mcg subcutaneously, when follicular response is adequate (that is, at least 1 follicle with a diameter of greater than or equal to [>=] 18 millimeter [mm], two or more additional follicles with a diameter of >= 16 mm, and Estradiol [E2] levels will approximately 150 picogram per milliliter [pg/mL] per mature follicle).
    Other Names:
  • Ovidrel®
  • Choriogonadotropin alfa
  • Outcome Measures

    Primary Outcome Measures

    1. Number of Fertilized Oocytes (2 Pronuclei [PN]) [Ovum pick-up (OPU) day (34-38 hours post r-hCG administration day [end of stimulation cycle {approximately 21 days}])]

      Oocytes were fertilized using Intra-cytoplasmic Sperm Injection (ICSI) technique which is an in-vitro fertilization procedure in which a single sperm is injected directly into an egg under a microscope. The appearance of 2PN is the first sign of successful fertilization as observed during in vitro fertilization, and is usually observed after ICSI. The zygote is then termed 2PN.

    Secondary Outcome Measures

    1. Percentage of Participants With Clinical Pregnancy [Day 35-42 post r-hCG administration day (end of stimulation cycle [approximately 21 days])]

      Clinical pregnancy was defined as the presence of one or more fetal sacs with fetal heart activity on the Day 35-42 post r-hCG ultrasound examination.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 36 Years
    Sexes Eligible for Study:
    Female
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria :
    • Infertility and desire to conceive, justifying ART treatment

    • Age between 18 and 36 years, inclusive, at time of informed consent

    • Body mass index (BMI) 18 to 30 kilogram per square meter (kg/m^2), inclusive

    • Regular spontaneous menstrual cycles of 21 to 35 days

    • Presence of both ovaries

    • Transvaginal ultrasound within 6 weeks and hysterosalpingogram, hysterosonogram or hysteroscopy within 2 years prior to beginning OCP treatment, showing no clinically significant uterine abnormality, which, in the Investigator's opinion, could impair embryo implantation or pregnancy continuation

    • Normal early follicular phase (Day 2-4) serum FSH level, according to the local laboratory

    • Normal serum thyroid stimulating hormone (TSH) level, according to the local laboratory

    • Papanicolaou (PAP) smear test without clinically significant abnormalities within the last 6 months prior to beginning oral contraceptive therapy,

    • Negative pregnancy test prior to beginning GnRH-agonist therapy

    • Male partner with semen analysis which is at least adequate for ICSI within last 6 months prior to beginning GnRH agonist therapy, according to local laboratory

    • Willing and able to comply with the protocol

    • Voluntary provision of written informed consent, prior to any study-related procedure that was not part of normal medical care, with the understanding that the subject could withdraw consent at any time without prejudice to her future medical care, and

    • Willingness to provide follow-up information on babies born as part of this study

    • For subjects recruited at PK sub-study centers, voluntary provision of written informed consent to participate in the PK sub-study

    Exclusion Criteria:
    • Subject who require a starting dose of FSH greater than (>) 150 international unit per day (IU/day), in the opinion of the Investigator

    • Screening ultrasound demonstrating more than 12 follicles less than (<) 11 mm mean diameter in either ovary

    • Two or more previous ART cycles (consecutive or not) with poor response to gonadotrophin, defined as less than or equal to (=<)3 oocytes retrieved

    • Three or more previous consecutive ART cycles without a biochemical or clinical pregnancy

    • Previous failure of fertilization with ICSI

    • A previous ART attempt in which there were no adequate or motile sperm before or after the processing of ejaculated sperm

    • Previous severe OHSS

    • History or presence of tumors of the hypothalamus or pituitary gland

    • History or presence of ovarian, uterine or mammary cancer

    • History or presence of ovarian enlargement or cyst of unknown etiology, or presence of ovarian cyst >25 mm on the day of randomization

    • Presence of endometriosis Grade III - IV

    • Presence of uni- or bilateral hydrosalpinx

    • Abnormal gynecological bleeding of undetermined origin

    • Contraindication to being pregnant and/or carrying a pregnancy to term

    • History of >= 3 clinical or preclinical (absence of gestational sac) miscarriages due to any cause

    • Extra-uterine pregnancy within the 3 months prior to randomization

    • Clinically significant concurrent disease that would have compromised subject safety or interfered with the study assessments

    • Known infection with human immunodeficiency virus (HIV), hepatitis B or C virus in the female or male partner

    • Known allergy or hypersensitivity to human gonadotrophin preparations or to compounds that are structurally similar to any of the other medications administered during the study

    • Any medical condition, which in the judgment of the Investigator may have interfere with the absorption, distribution, metabolism or excretion of r-hFSH

    • Any active substance abuse or history of drug, medication or alcohol abuse within 5 years before screening

    • ART cycle and/or ovarian stimulation within 30 days prior to informed consent

    • Entered previously into this study or simultaneous participation in another clinical trial

    • Subject is a smoker consuming more than 5 cigarettes per day

    • In the opinion of the Investigator, either assisted hatching or pre-implantation genetic diagnosis is indicated for the subject

    • Planning to undergo experimental procedures such as blastomere biopsy, or

    • Any known autoimmune disease

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Local US Medical Information Office Rockland Massachusetts United States 02370

    Sponsors and Collaborators

    • Merck KGaA, Darmstadt, Germany

    Investigators

    • Study Director: Zourab Bebia, MD, EMD Serono

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Merck KGaA, Darmstadt, Germany
    ClinicalTrials.gov Identifier:
    NCT00505752
    Other Study ID Numbers:
    • 27591
    First Posted:
    Jul 23, 2007
    Last Update Posted:
    Feb 13, 2014
    Last Verified:
    Jan 1, 2014
    Keywords provided by Merck KGaA, Darmstadt, Germany
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title AS900672-Enriched 50 Mcg AS900672-Enriched 100 Microgram (Mcg) AS900672-Enriched 150 Microgram (Mcg) Follitropin Alfa 150 IU
    Arm/Group Description Single injection of AS900672-Enriched (hyperglycosylated recombinant human follicle stimulating hormone [r-hFSH]), 50 microgram (mcg) administered subcutaneously on Stimulation day 1 (S1) followed by a daily dose of follitropin alfa 150 international unit (IU) subcutaneously starting from Stimulation Day 6 (S6) up to Stimulation Day 21 (S21) based upon ovarian response, until recombinant human chorionic gonadotropin (r-hCG, Ovidrel®) administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of greater than or equal to [>=] 18 millimeter [mm], two or more additional follicles with a diameter of >= 16 mm, and Estradiol [E2] levels were approximately 150 picogram per milliliter [pg/mL] per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 100 mcg administered subcutaneously on S1 followed by a daily dose of follitropin alfa 150 IU subcutaneously starting from S6 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 150 mcg administered subcutaneously on S1 followed by a daily dose of follitropin alfa 150 IU subcutaneously starting from S6 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Follitropin alfa (Gonal-f®) 150 IU administered subcutaneously once daily from S1 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days.
    Period Title: Overall Study
    STARTED 132 128 128 132
    COMPLETED 126 119 120 126
    NOT COMPLETED 6 9 8 6

    Baseline Characteristics

    Arm/Group Title AS900672-Enriched 50 Mcg AS900672-Enriched 100 Microgram (Mcg) AS900672-Enriched 150 Microgram (Mcg) Follitropin Alfa 150 IU Total
    Arm/Group Description Single injection of AS900672-Enriched (hyperglycosylated recombinant human follicle stimulating hormone [r-hFSH]), 50 microgram (mcg) administered subcutaneously on Stimulation day 1 (S1) followed by a daily dose of follitropin alfa 150 international unit (IU) subcutaneously starting from Stimulation Day 6 (S6) up to Stimulation Day 21 (S21) based upon ovarian response, until recombinant human chorionic gonadotropin (r-hCG, Ovidrel®) administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of greater than or equal to [>=] 18 millimeter [mm], two or more additional follicles with a diameter of >= 16 mm, and Estradiol [E2] levels were approximately 150 picogram per milliliter [pg/mL] per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 100 mcg administered subcutaneously on S1 followed by a daily dose of follitropin alfa 150 IU subcutaneously starting from S6 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 150 mcg administered subcutaneously on S1 followed by a daily dose of follitropin alfa 150 IU subcutaneously starting from S6 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Follitropin alfa (Gonal-f®) 150 IU administered subcutaneously once daily from S1 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Total of all reporting groups
    Overall Participants 132 128 128 132 520
    Age (years) [Median (Full Range) ]
    Median (Full Range) [years]
    32.0
    32.0
    32.0
    32.0
    32.0
    Sex: Female, Male (Count of Participants)
    Female
    132
    100%
    128
    100%
    128
    100%
    132
    100%
    520
    100%
    Male
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%

    Outcome Measures

    1. Primary Outcome
    Title Number of Fertilized Oocytes (2 Pronuclei [PN])
    Description Oocytes were fertilized using Intra-cytoplasmic Sperm Injection (ICSI) technique which is an in-vitro fertilization procedure in which a single sperm is injected directly into an egg under a microscope. The appearance of 2PN is the first sign of successful fertilization as observed during in vitro fertilization, and is usually observed after ICSI. The zygote is then termed 2PN.
    Time Frame Ovum pick-up (OPU) day (34-38 hours post r-hCG administration day [end of stimulation cycle {approximately 21 days}])

    Outcome Measure Data

    Analysis Population Description
    Intention-to-treat (ITT) population included all the participants who were randomized to study treatment. 'N' (number of participants analyzed) signifies participants who were evaluable for this measure.
    Arm/Group Title AS900672-Enriched 50 Mcg AS900672-Enriched 100 Microgram (Mcg) AS900672-Enriched 150 Microgram (Mcg) Follitropin Alfa 150 IU
    Arm/Group Description Single injection of AS900672-Enriched (hyperglycosylated recombinant human follicle stimulating hormone [r-hFSH]), 50 microgram (mcg) administered subcutaneously on Stimulation day 1 (S1) followed by a daily dose of follitropin alfa 150 international unit (IU) subcutaneously starting from Stimulation Day 6 (S6) up to Stimulation Day 21 (S21) based upon ovarian response, until recombinant human chorionic gonadotropin (r-hCG, Ovidrel®) administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of greater than or equal to [>=] 18 millimeter [mm], two or more additional follicles with a diameter of >= 16 mm, and Estradiol [E2] levels were approximately 150 picogram per milliliter [pg/mL] per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 100 mcg administered subcutaneously on S1 followed by a daily dose of follitropin alfa 150 IU subcutaneously starting from S6 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 150 mcg administered subcutaneously on S1 followed by a daily dose of follitropin alfa 150 IU subcutaneously starting from S6 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Follitropin alfa (Gonal-f®) 150 IU administered subcutaneously once daily from S1 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days.
    Measure Participants 130 122 124 131
    Mean (Standard Deviation) [2PN oocytes]
    7.0
    (4.7)
    8.7
    (4.9)
    9.2
    (6.0)
    6.7
    (4.2)
    2. Secondary Outcome
    Title Percentage of Participants With Clinical Pregnancy
    Description Clinical pregnancy was defined as the presence of one or more fetal sacs with fetal heart activity on the Day 35-42 post r-hCG ultrasound examination.
    Time Frame Day 35-42 post r-hCG administration day (end of stimulation cycle [approximately 21 days])

    Outcome Measure Data

    Analysis Population Description
    ITT population included all the participants who were randomized to study treatment. 'N' (number of participants analyzed) signifies participants who were evaluable for this measure.
    Arm/Group Title AS900672-Enriched 50 Mcg AS900672-Enriched 100 Microgram (Mcg) AS900672-Enriched 150 Microgram (Mcg) Follitropin Alfa 150 IU
    Arm/Group Description Single injection of AS900672-Enriched (hyperglycosylated recombinant human follicle stimulating hormone [r-hFSH]), 50 microgram (mcg) administered subcutaneously on Stimulation day 1 (S1) followed by a daily dose of follitropin alfa 150 international unit (IU) subcutaneously starting from Stimulation Day 6 (S6) up to Stimulation Day 21 (S21) based upon ovarian response, until recombinant human chorionic gonadotropin (r-hCG, Ovidrel®) administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of greater than or equal to [>=] 18 millimeter [mm], two or more additional follicles with a diameter of >= 16 mm, and Estradiol [E2] levels were approximately 150 picogram per milliliter [pg/mL] per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 100 mcg administered subcutaneously on S1 followed by a daily dose of follitropin alfa 150 IU subcutaneously starting from S6 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 150 mcg administered subcutaneously on S1 followed by a daily dose of follitropin alfa 150 IU subcutaneously starting from S6 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Follitropin alfa (Gonal-f®) 150 IU administered subcutaneously once daily from S1 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days.
    Measure Participants 128 120 122 128
    Number [Percentage of participants]
    39.1
    29.6%
    40.8
    31.9%
    35.2
    27.5%
    43.8
    33.2%

    Adverse Events

    Time Frame Stimulation Day 1 (S1) up to Day 35-42 post r-hCG administration day (end of stimulation cycle [approximately 21 days])
    Adverse Event Reporting Description An adverse event (AE) was defined as any untoward medical occurrence in the form of signs, symptoms, abnormal laboratory findings, or diseases that emerges or worsens relative to baseline during a clinical study with an investigational medicinal product (IMP), regardless of causal relationship and even if no IMP has been administered.
    Arm/Group Title AS900672-Enriched 50 Mcg AS900672-Enriched 100 Microgram (Mcg) AS900672-Enriched 150 Microgram (Mcg) Follitropin Alfa 150 IU
    Arm/Group Description Single injection of AS900672-Enriched (hyperglycosylated recombinant human follicle stimulating hormone [r-hFSH]), 50 microgram (mcg) administered subcutaneously on Stimulation day 1 (S1) followed by a daily dose of follitropin alfa 150 international unit (IU) subcutaneously starting from Stimulation Day 6 (S6) up to Stimulation Day 21 (S21) based upon ovarian response, until recombinant human chorionic gonadotropin (r-hCG, Ovidrel®) administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of greater than or equal to [>=] 18 millimeter [mm], two or more additional follicles with a diameter of >= 16 mm, and Estradiol [E2] levels were approximately 150 picogram per milliliter [pg/mL] per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 100 mcg administered subcutaneously on S1 followed by a daily dose of follitropin alfa 150 IU subcutaneously starting from S6 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Single injection of AS900672-Enriched (hyperglycosylated r-hFSH), 150 mcg administered subcutaneously on S1 followed by a daily dose of follitropin alfa 150 IU subcutaneously starting from S6 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days. Follitropin alfa (Gonal-f®) 150 IU administered subcutaneously once daily from S1 up to S21 based upon ovarian response, until r-hCG administration day. When follicular response was adequate (that is, at least 1 follicle with a diameter of >= 18 mm, two or more additional follicles with a diameter of >= 16 mm, and E2 levels were approximately 150 pg/mL per mature follicle), ovulation was triggered by single 250 mcg subcutaneous r-hCG injection. Duration of treatment cycle was up to adequate follicular response or maximum of 21 days.
    All Cause Mortality
    AS900672-Enriched 50 Mcg AS900672-Enriched 100 Microgram (Mcg) AS900672-Enriched 150 Microgram (Mcg) Follitropin Alfa 150 IU
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total / (NaN) / (NaN) / (NaN) / (NaN)
    Serious Adverse Events
    AS900672-Enriched 50 Mcg AS900672-Enriched 100 Microgram (Mcg) AS900672-Enriched 150 Microgram (Mcg) Follitropin Alfa 150 IU
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 5/132 (3.8%) 5/128 (3.9%) 4/128 (3.1%) 6/132 (4.5%)
    Congenital, familial and genetic disorders
    Ventriculo septal defect 1/132 (0.8%) 0/128 (0%) 0/128 (0%) 0/132 (0%)
    Cryptorchism 1/132 (0.8%) 0/128 (0%) 0/128 (0%) 0/132 (0%)
    Heart disease congenital 0/132 (0%) 0/128 (0%) 0/128 (0%) 1/132 (0.8%)
    Hepatobiliary disorders
    Cholecystitis 0/132 (0%) 1/128 (0.8%) 0/128 (0%) 0/132 (0%)
    Hepatic steatosis 0/132 (0%) 0/128 (0%) 0/128 (0%) 1/132 (0.8%)
    Infections and infestations
    Gastroenteritis viral 1/132 (0.8%) 0/128 (0%) 0/128 (0%) 0/132 (0%)
    Injury, poisoning and procedural complications
    Clavicle fracture 0/132 (0%) 0/128 (0%) 1/128 (0.8%) 0/132 (0%)
    Pregnancy, puerperium and perinatal conditions
    Abortion spontaneous 0/132 (0%) 1/128 (0.8%) 0/128 (0%) 0/132 (0%)
    Heterotopic pregnancy 0/132 (0%) 1/128 (0.8%) 0/128 (0%) 0/132 (0%)
    Premature rupture of membranes 0/132 (0%) 0/128 (0%) 0/128 (0%) 1/132 (0.8%)
    Ruptured ectopic pregnancy 0/132 (0%) 1/128 (0.8%) 0/128 (0%) 0/132 (0%)
    Ectopic pregnancy 1/132 (0.8%) 0/128 (0%) 2/128 (1.6%) 0/132 (0%)
    Umbilical cord abnormality 0/132 (0%) 0/128 (0%) 0/128 (0%) 1/132 (0.8%)
    Reproductive system and breast disorders
    Ovarian Hyperstimulation Syndrome 0/132 (0%) 1/128 (0.8%) 1/128 (0.8%) 1/132 (0.8%)
    Ovarian torsion 0/132 (0%) 0/128 (0%) 0/128 (0%) 1/132 (0.8%)
    Pelvic pain 1/132 (0.8%) 0/128 (0%) 0/128 (0%) 0/132 (0%)
    Other (Not Including Serious) Adverse Events
    AS900672-Enriched 50 Mcg AS900672-Enriched 100 Microgram (Mcg) AS900672-Enriched 150 Microgram (Mcg) Follitropin Alfa 150 IU
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 90/132 (68.2%) 85/128 (66.4%) 84/128 (65.6%) 82/132 (62.1%)
    Gastrointestinal disorders
    Abdominal distension 15/132 (11.4%) 16/128 (12.5%) 22/128 (17.2%) 22/132 (16.7%)
    Nausea 11/132 (8.3%) 10/128 (7.8%) 12/128 (9.4%) 16/132 (12.1%)
    Constipation 3/132 (2.3%) 5/128 (3.9%) 7/128 (5.5%) 3/132 (2.3%)
    General disorders
    Fatigue 5/132 (3.8%) 4/128 (3.1%) 4/128 (3.1%) 8/132 (6.1%)
    Injury, poisoning and procedural complications
    Procedural pain 35/132 (26.5%) 29/128 (22.7%) 27/128 (21.1%) 39/132 (29.5%)
    Musculoskeletal and connective tissue disorders
    Back pain 3/132 (2.3%) 8/128 (6.3%) 4/128 (3.1%) 4/132 (3%)
    Nervous system disorders
    Headache 23/132 (17.4%) 22/128 (17.2%) 22/128 (17.2%) 28/132 (21.2%)
    Reproductive system and breast disorders
    Adnexa uteri pain 20/132 (15.2%) 14/128 (10.9%) 14/128 (10.9%) 15/132 (11.4%)
    Uterine spasm 3/132 (2.3%) 7/128 (5.5%) 11/128 (8.6%) 5/132 (3.8%)
    Ovarian hyperstimulation syndrome 6/132 (4.5%) 5/128 (3.9%) 10/128 (7.8%) 6/132 (4.5%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    Results Point of Contact

    Name/Title Merck KGaA Communication Center
    Organization Merck Serono, a division of Merck KGaA
    Phone +49-6151-72-5200
    Email service@merckgroup.com
    Responsible Party:
    Merck KGaA, Darmstadt, Germany
    ClinicalTrials.gov Identifier:
    NCT00505752
    Other Study ID Numbers:
    • 27591
    First Posted:
    Jul 23, 2007
    Last Update Posted:
    Feb 13, 2014
    Last Verified:
    Jan 1, 2014