Large, comparative, randomized double-blind trial confirming noninferiority of pregnancy rates for corifollitropin alfa compared with recombinant follicle-stimulating hormone in a gonadotropin-releasing hormone antagonist controlled ovarian stimulation protocol in older patients undergoing in vitro fertilization.

Abstract

OBJECTIVE:

To compare corifollitropin alfa with recombinant FSH treatment in terms of the vital pregnancy rate in older patients undergoing IVF.

DESIGN:

Phase 3 randomized, double-blind, noninferiority trial.

SETTING:

Multicenter trial.

PATIENT(S):

A total of 1,390 women aged 35-42 years.

INTERVENTION(S):

A single injection of 150 μg of corifollitropin alfa or daily 300 IU of recombinant FSH for the first 7 days then daily recombinant FSH until three follicles reach ≥17 mm in size. Ganirelix was started on stimulation day 5 up to and including the day of recombinant hCG administration. If available, two good quality embryos were transferred on day 3.

MAIN OUTCOME MEASURE(S):

Vital pregnancy rate (PR), number of oocytes, and live birth rate.

RESULT(S):

Vital PRs per started cycle were 23.9% in the corifollitropin alfa group and 26.9% in the recombinant FSH group, with an estimated difference (95% confidence interval) of -3.0% (-7.4 to 1.4). The mean (SD) number of recovered oocytes per started cycle was 10.7 (7.2) and 10.3 (6.8) in the corifollitropin alfa and the recombinant FSH groups, respectively, with an estimated difference of 0.5 (-0.2 to 1.2). The live birth rates per started cycle were 21.3% in the corifollitropin alfa group and 23.4% in the recombinant FSH group, with an estimated difference (95% confidence interval) -2.3% (-6.5 to 1.9). The incidence of serious adverse events was 0.4% versus 2.7% in the corifollitropin alfa and recombinant FSH groups, respectively, and of ovarian hyperstimulation syndrome (OHSS; all grades) was 1.7% in both groups.

CONCLUSION(S):

Treatment with corifollitropin alfa was proven noninferior to daily recombinant FSH with respect to vital PRs, number of oocytes retrieved, and live birth rates, and was generally well tolerated.

CLINICAL TRIAL REGISTRATION NUMBER:

NCT01144416.

• Authors: Robert Boostanfar, Bruce Shapiro, Michael Levy, Zev Rosenwaks, Han Witjes, Barbara J Stegmann, Jolanda Elbers, Keith Gordon, Bernadette Mannaerts, Pursue investigators
• Journal: Fertility and sterility (Fertil Steril) Vol. 104 Issue 1 Pg. 94-103.e1 (Jul 2015) ISSN: 1556-5653 [Electronic] United States
• PMID: 26003273 (Publication Type: Clinical Trial, Phase III, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Chemical References

• Follicle Stimulating Hormone, Human
• Hormone Antagonists
• Recombinant Proteins
• follicle stimulating hormone, human, with HCG C-terminal peptide
• Gonadotropin-Releasing Hormone
• Follicle Stimulating Hormone
• ganirelix

Topics

• Adult
• Age Factors
• Double-Blind Method
• Female
• Fertilization in Vitro (methods, trends)
• Follicle Stimulating Hormone (administration & dosage)
• Follicle Stimulating Hormone, Human (administration & dosage)
• Gonadotropin-Releasing Hormone (administration & dosage, analogs & derivatives, antagonists & inhibitors)
• Hormone Antagonists (administration & dosage)
• Humans
• Ovulation Induction (methods, trends)
• Pregnancy
• Pregnancy Rate (trends)
• Recombinant Proteins (administration & dosage)