Administration of Methylprednisolone for Prevention of Ovarian Hyper Stimulation Syndrome
Administration of Methylprednisolone for Prevention of Ovarian Hyper Stimulation Syndrome in In-vitro Fertilization Cycles: A Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Ovarian hyper stimulation syndrome is the most serious complication of ovarian stimulation which might be life threatening in the severe forms. Since there is still no definite cure for this syndrome, prevention is considered as an essential and vital issue. The objective of this study is to determine the effect of Methylprednisolone to prevent ovarian hyper stimulation syndrome in IVF cycles.
The study population comprises all infertile patients with diagnosis of polycystic ovarian syndrome which will undergo of in-vitro fertilization. The PCO subjects will be recognized based on the Rotterdam criteria inclusive the presence of least 2 signs of oligomenorrhea, hyper androgynism (clinical or laboratory), LH/FSH>2 and ovarian morphological evidences in Doppler ultrasound.
The existence of more than 20 follicles in both ovaries and E2 concentration >4000 pg/ml will be considered as the OHSS risk factors.
In this study all eligible patients will be randomly allocated into two study groups by a computerized randomization method:
Treatment group (case) will be administered 16 mg Methylprednisolone initiated from the first day of stimulation and will be tapered after the first pregnancy test (day 13 after the embryo transfer). Furthermore, these patients will receive a bolus IV dose methylprednisolone, 1g on the day of egg collection and embryo transfer.
Patients in the control group will not receive any treatment with glucocorticoids. If each group confronts with every kind of high risk signs or symptoms, they will undergo coasting or gonadotropin withdrawal or other treatment strategies.
The presence of OHSS is defined in accordance with the Golan 5 grade system and women who at least are at grade 2 of this classification (Mild) considered as OHSS cases and will experience abdominal distention and discomfort, nausea and vomiting and/or diarrhea and enlargement of ovaries(5-12cm). In Moderate forms, ultrasound evidences of ascites will be observed and severe OHSS accompany with clinical signs of ascites, hydrothorax, breathing disorders, hemoconcentration, coagulopathy and renal perfusion decrease.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
-
Tehran, Iran, Islamic Republic of, 14114
- Royan Institute
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Poly Cystic Ovarian Syndrome patients
- Indication for IVF/ICSI and Long Protocol ovarian stimulation
- Basal FSH≥10
- Normal BMI (20-25)
- physical health
Exclusion Criteria:
- Allergy to GnRH analogues, FSH and corticosteroids
- presence of heart failure, recent myocardial infarction
- Hypertension
- Diabetes mellitus
- epilepsy
- glaucoma
- hypothyroidism
- hepatic failure
- osteoporosis
- peptic ulceration
- renal impairment
- Using drugs that have interaction with corticosteroids such
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Sham Comparator: Control
|
Normal salin injection
|
|
Experimental: Case
Administration of Methylprednisolone
|
Administration of Methylprednisolone
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Occurrence rate of Ovarian hyper stimulation syndrome
Time Frame: Until 20 days after embryos transfer
|
Until 20 days after embryos transfer
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Estradiol concentration in the day before hCG administration
Time Frame: Until 20 days after embryos transfer
|
Until 20 days after embryos transfer
|
|
Retrieved and injected oocytes number and quality
Time Frame: Until 20 days after embryos transfer
|
Until 20 days after embryos transfer
|
|
Achieved and transferred embryos number and quality
Time Frame: Until 20 days after embryos transfer
|
Until 20 days after embryos transfer
|
|
Implantation rate
Time Frame: Until 20 days after embryos transfer
|
Until 20 days after embryos transfer
|
|
Chemical and clinical pregnancy rate and cancelation rate
Time Frame: Until 20 days after embryos transfer
|
Until 20 days after embryos transfer
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Ashraf Moini, MD, Endocrinology and Female Infertility Department, Reproductive Medicine Research Center, Royan institute, ACECR, Tehran, Iran
- Principal Investigator: Marzieh Shiva, MD, Endocrinology and Female Infertility Department, Reproductive Medicine Research Center, Royan institute, ACECR, Tehran, Iran
- Principal Investigator: Narges bagheri lankarani, MD, Endocrinology and Female Infertility Department, Reproductive Medicine Research Center, Royan institute, ACECR, Tehran, Iran
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Endocrine System Diseases
- Disease
- Ovarian Diseases
- Adnexal Diseases
- Gonadal Disorders
- Syndrome
- Ovarian Hyperstimulation Syndrome
- Physiological Effects of Drugs
- Autonomic Agents
- Peripheral Nervous System Agents
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Antiemetics
- Gastrointestinal Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Neuroprotective Agents
- Protective Agents
- Prednisolone
- Methylprednisolone Acetate
- Methylprednisolone
- Methylprednisolone Hemisuccinate
- Prednisolone acetate
- Prednisolone hemisuccinate
- Prednisolone phosphate
Other Study ID Numbers
Other Study ID Numbers
- Royan-Emb-005
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