Concomitant CC and E2 Versus CC Alone in Ovulation Induction

Overview

The purpose of this study is to evaluate the effect of concomitant administration of estradiol during use of clomiphene citrate (CC) for induction of ovulation in infertile women.

Full Title of Study: “Concomitant Clomiphene Citrate and Estradiol Versus Clomiphene Citrate Alone in Ovulation Induction: a Randomized Controlled Trial”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: July 2018

Detailed Description

Women will be randomly divided into two groups; CC-E2 group and CC group. Women in the CC-E2 group will receive CC (100 mg/day for 5 consecutive days from day 2 of cycle) and estradiol (2 mg/day for 5 consecutive days from day 2 of cycle). Women in the CC group will receive CC (100 mg/day for 5 consecutive days from day 2 of cycle) and placebo mimic estradiol (for 5 consecutive days from day 2 of cycle). Transvaginal sonography (TVS) scan will be performed regularly for monitoring of follicular growth (folliculometry); starting from day 10 of the stimulation cycle and repeated every 2-3 days. When there will be at least one follicle ≥ 18 mm in diameter, final oocyte maturation will be induced by intramuscular administration of 10000 IU of human chorionic gonadotropin (HCG) and timed intercourse will be advised. If there will be no follicle ≥ 12 mm by day 16 of the cycle, monitoring of follicular growth will be discontinued and the cycle will be presumed to be anovulatory. Ovulation will be documented by TVS scan one week after triggering of oocyte maturation and will be confirmed by assessing the midluteal serum progesterone level. Each woman will be subjected to ovarian stimulation for a maximum of 3 consecutive cycles except if she gets pregnant in the first or second cycle.

Interventions

  • Drug: Clomiphene citrate and Estradiol
    • Women will receive clomiphene citrate (100 mg/day for 5 consecutive days from day 2 of cycle) and estradiol (2 mg/day for 5 consecutive days from day 2 of cycle)
  • Drug: Clomiphene citrate and Placebo
    • Women will receive clomiphene citrate (100 mg/day for 5 consecutive days from day 2 of cycle) and placebo (for 5 consecutive days from day 2 of cycle)

Arms, Groups and Cohorts

  • Active Comparator: Clomiphene citrate-Estradiol group
    • Women will receive clomiphene citrate and estradiol
  • Active Comparator: Clomiphene citrate group
    • Women will receive clomiphene citrate and placebo

Clinical Trial Outcome Measures

Primary Measures

  • Clinical pregnancy rate
    • Time Frame: 6-8 weeks gestational age
    • Number of clinical pregnancies (defined as presence of at least one intrauterine gestational sac with fetal pole and cardiac activity on TVS scan at 6-8 weeks gestational age) divided by the number of women

Secondary Measures

  • Endometrial thickness on day of HCG administration
    • Time Frame: 3 months
    • Endometrial thickness by TVS on day of HCG administration

Participating in This Clinical Trial

Inclusion Criteria

  • Infertile women with eugonadotrophic anovulation/oligoovulation. – Unexplained infertility. Exclusion Criteria:

  • Age < 20 or > 35 years. – Body mass index (BMI) < 18.5 kg/m2 or > 25 kg/m2. – Presence of any infertility factor other than anovulation/oligoovulation. – Previous history of ovarian surgery or surgical removal of one ovary. – Previous exposure to cytotoxic drugs or pelvic irradiation. – Metabolic or hormonal abnormalities.

Gender Eligibility: Female

Minimum Age: 20 Years

Maximum Age: 39 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Maher elesawi kamel elesawi
  • Provider of Information About this Clinical Study
    • Sponsor-Investigator: Maher elesawi kamel elesawi, Dr – Mansoura University
  • Overall Official(s)
    • Ahmed M Badawy, Prof, Principal Investigator, Mansoura University
    • Maher E Kamel Elesawi, Dr, Study Director, Mansoura University
    • Mohamed S Abdelhafez, Dr, Study Director, Mansoura University
  • Overall Contact(s)
    • Maher E Kamel Elesawi, Dr, +201016103662, maherelesawi@yahoo.com

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