- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03252223
Ovarian Response to Recombinant Follicle Stimulating Hormone in Women With PCOS
September 6, 2021 updated by: Jeffrey Chang, MD, University of California, San Diego
Ovarian Function in Women With Polycystic Ovary Syndrome
Women with PCOS suffer from anovulation and, as a result, infertility.
Efforts to clinically induce ovulation in these women using follicle stimulating hormone (FSH) administered subcutaneously seemingly requires prolonged administration compared to that of ovulatory women without PCOS.
The apparent differing ovarian responsiveness to FSH between PCOS and normal women has not been carefully studied.
We propose to address this issue by performing a dose-response study and examine ovarian follicle (estrogen, E2) responses to FSH administered subcutaneously in women with PCOS compared to responses observed in normal women.
Study Overview
Status
Completed
Intervention / Treatment
Detailed Description
In women with polycystic ovary syndrome (PCOS) androgen excess is fundamental to the clinical and physiological alterations of this disorder.
In particular, androgen overproduction induces distinctive PCO morphology and appears to influence follicle function.
Studies conducted in animals and nonhuman primates have demonstrated that androgens increase follicle number and in small antral follicles enhance granulosa cell (GC) responsiveness to gonadotropin stimulation.
However, androgens also have been shown to clearly inhibit GC aromatase activity, and in PCOS follicular fluid, androgen content is abnormally increased.
Efforts to reconcile these differences are nonexistent.
Moreover, appropriate clinical studies to examine the effects of androgen on follicle health in women are lacking.
Excessive androgen exposure in women due to functional tumors or high-dose testosterone treatment in F-M transsexuals has been associated with PCO morphology.
Use of androgen therapy to promote follicle growth prior to ovarian hyperstimulation in women undergoing in vitro fertilization has not provided consistent results.
However, in these studies GC responses to FSH were not carefully assessed, study populations were exclusively women with previously poor ovarian responses to FSH, and women with PCOS were not included.
In fact, there are essentially no clinical studies that have addressed in detail the impact of androgen on follicle function in normal or PCOS women.
We hypothesize that androgen facilitates GC responses to FSH in normal women and androgen excess further amplifies follicle growth and function in women with PCOS.
We propose to study the effect of increased ovarian androgen on follicle function by increasing intraovarian androgen accumulation using aromatase inhibition followed by FSH stimulation.
The experiments in this project are designed to provide insight into whether androgen excess facilitates or interferes with follicle function and ovulation in women with PCOS.
Study Type
Interventional
Enrollment (Actual)
33
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
California
-
La Jolla, California, United States, 92037
- University of California, San Diego
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 37 years (ADULT)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- Subjects determined to have PCOS based on clinical history of irregular menses and clinical or laboratory evidence of hyperandrogenism and polycystic ovaries on ultrasound OR
- Subjects determined to have a clinical history of regular periods.
Exclusion Criteria:
- Women with hemoglobin less than 11 gm/dl at screening evaluation
- Women with untreated thyroid abnormalities
- Pregnant women or women who are nursing
- Women with BMI > 37
- Women with known sensitivity to the agents being used
- Women with diabetes, or renal, liver, or heart disease
- Women with any hormonal therapy or metformin for at least 2 months prior to study start.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: OTHER
- Allocation: NON_RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Women with normal menses
|
A modified dose-response study will be done using recombinant FSH (r-FSH), injected sc for 3 days at any one dose.
r-FSH will be administered at weight-adjusted doses equivalent to 37.5, 75, and 150 IU based on an average weight of 70 kg, which approximates the weight of the average woman in the United States according to the Centers for Disease Control.
Therefore, the actual dose of r-FSH will be 0.53 IU/kg for the 37.5 dose group.
Accordingly, r-FSH will be repeated at doses of 1.1 IU/kg and 2.2 IU/kg that are equivalent to 75 and 150 IU for a 70 kg subject.
Each FSH stimulation test will be assigned randomly and be separated by an interval of 8 weeks.
|
ACTIVE_COMPARATOR: Women with Polycystic Ovary Syndrome
|
A modified dose-response study will be done using recombinant FSH (r-FSH), injected sc for 3 days at any one dose.
r-FSH will be administered at weight-adjusted doses equivalent to 37.5, 75, and 150 IU based on an average weight of 70 kg, which approximates the weight of the average woman in the United States according to the Centers for Disease Control.
Therefore, the actual dose of r-FSH will be 0.53 IU/kg for the 37.5 dose group.
Accordingly, r-FSH will be repeated at doses of 1.1 IU/kg and 2.2 IU/kg that are equivalent to 75 and 150 IU for a 70 kg subject.
Each FSH stimulation test will be assigned randomly and be separated by an interval of 8 weeks.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in granulosa cell function in 24 hours intervals following FSH administration
Time Frame: Serum levels will be assessed daily during each 3 day FSH stimulation test and for five days following the initial FSH administration
|
Granulosa function will be assessed using estradiol and inhibin levels
|
Serum levels will be assessed daily during each 3 day FSH stimulation test and for five days following the initial FSH administration
|
Change in follicle count in following FSH administration
Time Frame: With each dose tested, a pelvic ultrasound will be done before and 3 days after commencing FSH
|
Number of ovarian follicles will be assessed by pelvic ultrasound
|
With each dose tested, a pelvic ultrasound will be done before and 3 days after commencing FSH
|
Change in follicular size in following FSH administration
Time Frame: With each dose tested, a pelvic ultrasound will be done before and 3 days after commencing FSH
|
Size of ovarian follicles will be assessed by pelvic ultrasound
|
With each dose tested, a pelvic ultrasound will be done before and 3 days after commencing FSH
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: R. Jeffrey Chang, MD, University of California, San Diego
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
October 2, 2017
Primary Completion (ACTUAL)
June 30, 2021
Study Completion (ACTUAL)
June 30, 2021
Study Registration Dates
First Submitted
August 8, 2017
First Submitted That Met QC Criteria
August 14, 2017
First Posted (ACTUAL)
August 17, 2017
Study Record Updates
Last Update Posted (ACTUAL)
September 8, 2021
Last Update Submitted That Met QC Criteria
September 6, 2021
Last Verified
September 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplasms
- Endocrine System Diseases
- Disease
- Ovarian Cysts
- Cysts
- Ovarian Diseases
- Adnexal Diseases
- Gonadal Disorders
- 46, XX Disorders of Sex Development
- Disorders of Sex Development
- Urogenital Abnormalities
- Adrenogenital Syndrome
- Congenital Abnormalities
- Polycystic Ovary Syndrome
- Hyperandrogenism
- Syndrome
- Anovulation
- Physiological Effects of Drugs
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Follicle Stimulating Hormone
- Hormones
Other Study ID Numbers
- 170684
- P50HD012303 (NIH)
- K12HD001259 (NIH)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Healthy
-
Prevent Age Resort "Pervaya Liniya"RecruitingHealthy Aging | Healthy Diet | Healthy LifestyleRussian Federation
-
Maastricht University Medical CenterCompletedHealthy Volunteers | Healthy Subjects | Healthy AdultsNetherlands
-
Yale UniversityNot yet recruitingHealth-related Benefits of Introducing Table Olives Into the Diet of Young Adults: Olives For HealthHealthy Diet | Healthy Lifestyle | Healthy Nutrition | CholesterolUnited States
-
Hasselt UniversityRecruitingHealthy | Healthy AgingBelgium
-
Galera Therapeutics, Inc.Syneos HealthCompleted
-
Galera Therapeutics, Inc.Syneos HealthCompletedHealthy | Healthy VolunteersAustralia
-
University of PennsylvaniaActive, not recruitingHealthy | Healthy AgingUnited States
-
Chalmers University of TechnologyGöteborg UniversityCompletedHealthy | Nutrition, HealthySweden
-
University of ManitobaNot yet recruitingHealthy | Healthy Diet
-
King's College LondonUniversity of ReadingCompletedHealthy | Healthy AgingUnited Kingdom
Clinical Trials on Recombinant Follicle Stimulating Hormone
-
Instituto BernabeuUnknownReproductive Techniques, AssistedSpain
-
Instituto Valenciano de Infertilidad, IVI VALENCIACompletedOvarian StimulationSpain
-
Rigshospitalet, DenmarkOdense University Hospital; Karolinska University Hospital; Hvidovre University... and other collaboratorsCompleted
-
Royan InstituteUnknown
-
Merck KGaA, Darmstadt, GermanyMerck, S.L., SpainTerminatedInfertility | Ovulation InductionSpain
-
National and Kapodistrian University of AthensCompleted
-
Merck KGaA, Darmstadt, GermanyTerminatedInfertility | Monofollicular DevelopmentUnited Kingdom, Ireland
-
Merck KGaA, Darmstadt, GermanyCompleted
-
Merck KGaA, Darmstadt, GermanyCompleted
-
Merck KGaA, Darmstadt, GermanyMerck N.V.-S.A., BelgiumTerminated