Clinical trial • Phase IV • Other

FOLLITROPIN ALFA for Female infertility | Low ovarian sensitivity (POSEIDON group 2)

Phase IV trial of FOLLITROPIN ALFA for Female infertility | Low ovarian sensitivity (POSEIDON group 2).

Overview

Trial Therapeutic Area
Other
Trial Disease
Female infertility | Low ovarian sensitivity (POSEIDON group 2)
Trial Stage
Phase IV
Drug Modality
Peptide/protein/enzyme | Small molecule

Key dates

Initial CTIS Submission Date
13-09-2024
First CTIS Authorization Date
23-09-2024

Trial design

Randomised, pergoveris (rhfsh + rhlh combination) versus gonal-f (rhfsh alone). trial compares 300 iu rhfsh + 150 iu rhlh (pergoveris) versus 300 iu rhfsh alone (gonal-f) in a gnrh antagonist protocol. auxiliary/support medications listed include cetrotide 0.25 mg (subcutaneous), crinone 8% vaginal gel (progesterone), and ovitrelle 250 micrograms (trigger).-controlled Phase IV trial across 4 sites in Spain.

Randomised
Yes
Comparator
Pergoveris (rhFSH + rhLH combination) versus Gonal-F (rhFSH alone). Trial compares 300 IU rhFSH + 150 IU rhLH (Pergoveris) versus 300 IU rhFSH alone (Gonal-F) in a GnRH antagonist protocol. Auxiliary/support medications listed include Cetrotide 0.25 mg (subcutaneous), Crinone 8% vaginal gel (progesterone), and Ovitrelle 250 micrograms (trigger).
Target Sample Size
120

Eligibility

Recruits 120 No vulnerable populations selected; participants are adult women (Age: ≥35 ≤40) who must be able and willing to sign the Patient Consent Form. Informed consent is required from the participant herself; consent forms are provided (English and Spanish). No assent procedures are specified..

Pregnancy Exclusion
Recent history of severe disease requiring regular treatment (Clinically significant concurrent medical condition that could compromise subject safety or interfered with the trial assessment and patients with any contraindication to pregnancy).
Vulnerable Population
No vulnerable populations selected; participants are adult women (Age: ≥35 ≤40) who must be able and willing to sign the Patient Consent Form. Informed consent is required from the participant herself; consent forms are provided (English and Spanish). No assent procedures are specified.

Inclusion criteria

  • {"criterion_text":"- POSEIDON group 2 patients\n- Able and willing to sign the Patient Consent Form and adhere to study visitation schedule.\n- Age: ≥ 35 years ≤40 years old.\n- antral Follicle Count (AFC) ≥5 and /or antimullerian hormone (AMH) ≥1.2 ng/mL.\n- <4 or 4-9 oocytes retrieved in a previous IVF/ICSI cycle with a starting dose of ≤225IU with any gonadotropin under a GnRH antagonist protocol.\n- Up to 3 previous ovarian stimulation cycles with a starting dose of ≤225IU in which dose adjustments during stimulation did not exceed 300IU.\n- Ovarian stimulation for IVF/ICSI"}

Exclusion criteria

  • {"criterion_text":"- Poor ovarian responders according to the Bologna criteria.\n- Contraindications for the use of medicine used for ovarian stimulation (gonadotropins, GnRH antagonist, progesterone vaginal gel)\n- Recent history of severe disease requiring regular treatment (Clinically significant concurrent medical condition that could compromise subject safety or interfered with the trial assessment and patients with any contraindication to pregnancy).\n- PGT-a (Preimplantation Genetic Testing for Aneuploidies).\n- TESA or TESE (Testicular Sperm Aspiration or Testicular Sperm Extraction)\n- PCOS patients according to the Rotterdam criteria.\n- AFC>20.\n- Age >40 or <35 years old.\n- Women with >10 oocytes retrieved in a previous IVF/ICSI cycle with 150-225 IU starting dose.\n- Women who required dose adjustments during stimulation >300 IU with any gonadotropin in their previous cycle\n- Uterine abnormalities.\n- Recent history of any current untreated endocrine abnormality.\n- Unilateral or bilateral hydrosalpinx (visible on USS, unless clipped)."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The primary efficacy endpoint is serum progesterone levels as well as P4/E2 ratio on the day of ovulation triggering. The primary efficacy endpoint is related to the primary trial objective.","definition_or_measurement_approach":"Serum progesterone levels and P4/E2 ratio measured on the day of ovulation triggering."}

Secondary endpoints

  • {"endpoint_text":"- Serum levels of estradiol, FSH, Testosterone and LH levels and P4/E2 ratio on days 1, 6, 8, 10 and the final day of oocyte maturation.","definition_or_measurement_approach":"Serum levels measured on days 1, 6, 8, 10 and the final day of oocyte maturation; P4/E2 ratio measured at these timepoints."}
  • {"endpoint_text":"- Progesterone-to-follicle Index (PFI) on the day of ovulation triggering","definition_or_measurement_approach":"PFI calculated on the day of ovulation triggering."}
  • {"endpoint_text":"- Number of oocytes.","definition_or_measurement_approach":"Count of oocytes retrieved per participant."}
  • {"endpoint_text":"- Number of patients with optimal number of oocytes retrieved (≥10 oocytes).","definition_or_measurement_approach":"Proportion of patients with ≥10 oocytes retrieved."}
  • {"endpoint_text":"- Number of embryos.","definition_or_measurement_approach":"Count of embryos generated per participant."}
  • {"endpoint_text":"- Good-quality embryos.","definition_or_measurement_approach":"Number or proportion of embryos meeting predefined 'good-quality' criteria (as per protocol)."}
  • {"endpoint_text":"- Number of blastocysts.","definition_or_measurement_approach":"Count of blastocysts per participant."}
  • {"endpoint_text":"- Clinical pregnancy defined as the presence of intrauterine gestational sac at 6-7 weeks of gestation.","definition_or_measurement_approach":"Clinical pregnancy assessed by ultrasound detection of intrauterine gestational sac at 6-7 weeks."}
  • {"endpoint_text":"- Ongoing pregnancy defined as the presence of intrauterine gestational sac with an embryonic pole demonstrating cardiac activity at 8-9 weeks of gestation.","definition_or_measurement_approach":"Ongoing pregnancy assessed by ultrasound detection of gestational sac with embryonic pole cardiac activity at 8-9 weeks."}

Recruitment

Planned Sample Size
120
Recruitment Window Months
72
Consent Approach
Participants must be able and willing to sign the Patient Consent Form (informed consent provided by the participant). Consent documentation is available in English and Spanish (documents L1_HIPCI PEARL EN and L1_HIPCI PEARL ESP). No assent procedures are specified.

Geography

Total Number Of Sites
4
Total Number Of Participants
120

Spain

Earliest CTIS Part Ii Submission Date
24-04-2024
Latest Decision Or Authorization Date
23-09-2024
Processing Time Days
152
Number Of Sites
4
Number Of Participants
120

Sites

Site Name
Hospital Clinic De Barcelona
Department Name
institut Clínic de Ginecologia, obstetricia i neonatologia (ICGON)
Contact Person Name
Dolors Manau
Contact Person Email
dmanau@clinic.cat
Site Name
Hospital Universitario 12 De Octubre
Department Name
Unidad de Reproducción Humana
Contact Person Name
Laura De la Fuente
Contact Person Email
lauradlfb@gmail.com
Site Name
Hospital Universitari Dexeus Grupo Quironsalud
Department Name
Department of Reproductive Medicine
Contact Person Name
Nikolaos Polyzos
Contact Person Email
nikpol@dexeus.com
Site Name
Hospital Universitario Quironsalud Madrid
Department Name
Unidad de Reproducción Asistida Servicio de Obstetricia y Ginecologia
Contact Person Name
Antonio Gosalvez
Contact Person Email
antonio.gosalvez@gmail.com

Sponsor

Primary sponsor

Full Name
Santiago Dexeus Fontacio Privada
Organisation Type
Laboratory/Research/Testing facility
Country Of Registered Address
Spain

Investigational products

Investigational Product Name
GONAL-f 900 IU/1.44 mL solution for injection in pre-filled pen
Active Substance
FOLLITROPIN ALFA
Modality
Peptide/protein/enzyme
Routes Of Administration
SUBCUTANEOUS USE
Route
Subcutaneous
Authorisation Status
Authorised
Starting Dose
300 IU (rhFSH) [as per trial arm]
Dose Levels
maxDailyDoseAmount: 300 IU; maxTotalDoseAmount: 4500 IU
Maximum Dose
300 IU (max daily)
Investigational Product Name
Pergoveris (900 IU + 450 IU)/1.44 mL solution for injection in pre-filled pen
Active Substance
FOLLITROPIN ALFA, LUTROPIN ALFA
Modality
Peptide/protein/enzyme
Routes Of Administration
SUBCUTANEOUS USE
Route
Subcutaneous
Authorisation Status
Authorised
Starting Dose
300 IU rhFSH + 150 IU rhLH (as per trial comparator arm)
Dose Levels
maxDailyDoseAmount: 300 IU; maxTotalDoseAmount: 4500 IU
Maximum Dose
300 IU (max daily rhFSH component)
Investigational Product Name
Cetrotide 0.25 mg powder and solvent for solution for injection
Active Substance
CETRORELIX
Modality
Peptide/protein/enzyme
Routes Of Administration
SUBCUTANEOUS USE
Route
Subcutaneous
Authorisation Status
Authorised
Starting Dose
0.25 mg (product name / typical dose)
Dose Levels
maxDailyDoseAmount: 0.25 mg; maxTotalDoseAmount: 2.25 mg
Maximum Dose
0.25 mg (max daily)
Investigational Product Name
Crinone 8% gel vaginal
Active Substance
PROGESTERONE
Modality
Small molecule
Routes Of Administration
VAGINAL USE
Route
Vaginal
Authorisation Status
Authorised
Dose Levels
maxDailyDoseAmount: 90 mg; maxTotalDoseAmount: 3780 mg
Maximum Dose
90 mg (max daily)
Investigational Product Name
Ovitrelle 250 micrograms solution for injection in pre-filled pen
Active Substance
CHORIOGONADOTROPIN ALFA
Modality
Peptide/protein/enzyme
Routes Of Administration
SUBCUTANEOUS USE
Route
Subcutaneous
Authorisation Status
Authorised
Starting Dose
250 micrograms (product name)
Dose Levels
maxDailyDoseAmount: 6500 IU (product data), maxTotalDoseAmount: 6500 IU
Maximum Dose
6500 IU (product max daily/total as listed)
Combination Treatment
Yes

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