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    Summary
    EudraCT Number:2022-000753-80
    Sponsor's Protocol Code Number:000298
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2022-06-10
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2022-000753-80
    A.3Full title of the trial
    A randomised, assessor-blind, active-controlled, parallel-group, dose-finding trial to investigate the efficacy and safety of FE 999302 for triggering of final follicular maturation in women undergoing controlled ovarian stimulation
    Un ensayo aleatorizado, enmascarado para los evaluadores, comparativo con tratamiento activo, de grupos paralelos y de búsqueda de dosis para investigar la eficacia y seguridad de FE 999302 para desencadenar la maduración folicular final en mujeres sometidas a estimulación ovárica controlada.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Clinical research study to learn about the effect and safety of different doses of FE 999302 when given as a single dose for final development of the eggs after ovarian stimulation
    Estudio de investigación clínica para conocer el efecto y la seguridad de diferentes dosis de FE 999302 cuando se administra como dosis única para el desarrollo final de los óvulos después de la estimulación ovárica
    A.3.2Name or abbreviated title of the trial where available
    TIFFANY
    TIFFANY
    A.4.1Sponsor's protocol code number000298
    A.5.3WHO Universal Trial Reference Number (UTRN)U1111-1272-6500
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorFerring Pharmaceuticals A/S
    B.1.3.4CountryDenmark
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportFerring Pharmaceuticals A(S
    B.4.2CountryDenmark
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationFerring Pharmaceuticals A/S
    B.5.2Functional name of contact pointGlobal Clinical Development
    B.5.3 Address:
    B.5.3.1Street AddressAmager Strandvej 405
    B.5.3.2Town/ cityKastrup
    B.5.3.3Post codeDK-2770
    B.5.3.4CountryDenmark
    B.5.4Telephone number+4588 33 88 34
    B.5.6E-mailDK0-Disclosure@ferring.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.2Product code FE 999302
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNChoriogonadotropin beta
    D.3.9.2Current sponsor codeFE 999302
    D.3.9.3Other descriptive nameHUMAN CHORIONIC GONADOTROPIN
    D.3.9.4EV Substance CodeSUB01277MIG
    D.3.10 Strength
    D.3.10.1Concentration unit µg/ml microgram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name NOVAREL
    D.2.1.1.2Name of the Marketing Authorisation holderFerring Pharmaceuticals Inc.
    D.2.1.2Country which granted the Marketing AuthorisationUnited States
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameNOVAREL
    D.3.2Product code FE 999086
    D.3.4Pharmaceutical form Powder and solvent for solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNChoriogonadotropin beta
    D.3.9.2Current sponsor codeFE 999086
    D.3.9.3Other descriptive nameHUMAN CHORIONIC GONADOTROPIN
    D.3.9.4EV Substance CodeSUB01277MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU international unit(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeUrinary derived
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name OVITRELLE
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Europe B.V.
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameOVITRELLE
    D.3.4Pharmaceutical form Solution for injection in pre-filled pen
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNChoriogonadotropin alfa
    D.3.9.1CAS number 177073-44-8
    D.3.9.3Other descriptive nameCHORIOGONADOTROPIN ALFA
    D.3.9.4EV Substance CodeSUB12481MIG
    D.3.10 Strength
    D.3.10.1Concentration unit µg/ml microgram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name OVITRELLE
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Europe B.V.
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameOVITRELLE
    D.3.4Pharmaceutical form Solution for injection in pre-filled syringe
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNChoriogonadotropin alfa
    D.3.9.1CAS number 177073-44-8
    D.3.9.3Other descriptive namechoriogonadotropin alfa
    D.3.9.4EV Substance CodeSUB12481MIG
    D.3.10 Strength
    D.3.10.1Concentration unit µg/ml microgram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Infertility
    Infertilidad
    E.1.1.1Medical condition in easily understood language
    Infertility
    Infertilidad
    E.1.1.2Therapeutic area Body processes [G] - Reproductive physiologi cal processes [G08]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level LLT
    E.1.2Classification code 10016398
    E.1.2Term Female infertility
    E.1.2System Organ Class 100000004872
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To compare the effect of 150, 200, and 250 μg of FE 999302 with 250 μg OVITRELLE and 10,000 IU NOVAREL on oocyte maturity when administered for triggering of final follicular maturation in women undergoing controlled ovarian stimulation
    Comparar el efecto de 150, 200 y 250 μg de FE 999302 con 250 μg de OVITRELLE y 10 000 UI de NOVAREL sobre la maduración de los ovocitos cuando se administran para desencadenar la maduración folicular final en mujeres sometidas a estimulación ovárica controlada.
    E.2.2Secondary objectives of the trial
    1. To compare the effect of 150, 200, and 250 μg of FE 999302 with 250 μg OVITRELLE and 10,000 IU NOVAREL on fertilisation, blastocyst quality, endocrine profile during the luteal phase, and pregnancy, when administered for triggering of final follicular
    maturation in women undergoing controlled ovarian stimulation
    2. To compare the safety of 150, 200, and 250 μg of FE 999302 with 250 μg OVITRELLE and 10,000 IU NOVAREL when administered for triggering of final follicular maturation in women undergoing controlled ovarian stimulation
    3. To investigate the impact of body weight on FE 999302 exposure and assess the population pharmacokinetics of FE 999302 when administered for triggering of final follicular maturation in women undergoing controlled ovarian stimulation
    1. Comparar el efecto de 150, 200 y 250 μg de FE 999302 con 250 μg de OVITRELLE y 10 000 UI de NOVAREL sobre la fecundación, la calidad de los blastocistos, el perfil endocrino durante la fase lútea y el embarazo, cuando se administra para desencadenar la maduración folicular final en mujeres sometidas a estimulación ovárica controlada.
    2. Comparar la seguridad de 150, 200 y 250 μg de FE 999302 con 250 μg de OVITRELLE y 10 000 UI de NOVAREL cuando se administran para desencadenar la maduración folicular final en mujeres sometidas a estimulación ovárica controlada.
    3. Investigar el efecto del peso corporal en la exposición al FE 999302 y evaluar la farmacocinética poblacional del FE 999302 cuando se administra para desencadenar la maduración folicular final en mujeres sometidas a estimulación ovárica controlada.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Subject informed consent form signed prior to any trial-related activities.
    2. Parental informed consent form signed prior to start of stimulation in the trial.
    3. In good physical and mental health as judged by the investigator.
    4. Pre-menopausal women between the ages of 18 and 42 years. The subjects must be at least 18 years (including the 18th birthday) and no more than 42 years (up to the day before the 43rd birthday) when they sign the informed consent
    5. Infertile women diagnosed with tubal infertility, unexplained infertility, endometriosis stage I/II or with partners diagnosed with male factor infertility, eligible for in vitro fertilisation (IVF) and/or intracytoplasmic sperm injection (ICSI) using fresh or frozen ejaculated sperm from male partner or sperm donor.
    6. Infertility for at least 1 year before screening for subjects <35 years or for at least 6 months for subjects ≥35 years (not applicable in case of tubal or severe male factor infertility).
    7. Early follicular phase (cycle day 2-4) serum levels of follicle-stimulating hormone (FSH) between 1 and 15 IU/L (results obtained within 3 months prior to start of stimulation in the trial).
    8. Follicular development with ≥3 follicles with a diameter ≥17 mm and <20 follicles with a diameter ≥12 mm observed on transvaginal ultrasound at the end of stimulation in the trial cycle.
    9. No more than two controlled ovarian stimulation cycles initiated, regardless outcome (taking exclusion criteria 3, 4, and 5 into account).
    10. Regular menstrual cycles of 24-35 days (both inclusive), presumed to be ovulatory.
    11. Hysterosalpingography, hysteroscopy, saline infusion sonography, or transvaginal ultrasound documenting a uterus consistent with expected normal function (e.g. no evidence of clinically interfering uterine fibroids defined as submucous or intramural fibroids larger than 3 cm in diameter, no polyps, and no congenital structural abnormalities which are associated with a reduced chance of pregnancy) within 1 year prior to start of stimulation in the trial.
    12. Transvaginal ultrasound documenting presence and adequate visualisation of both ovaries, without evidence of significant abnormality (e.g. enlarged ovaries which would contraindicate the use of gonadotropins) and normal adnexa (e.g. no hydrosalpinx) within 1 year prior to start of stimulation in the trial. Both ovaries must be accessible for oocyte retrieval.
    13. Negative serum Hepatitis B Surface Antigen (HBsAg), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) antibody tests within 1 year prior to start of stimulation in the trial.
    14. Willing to accept ICSI regardless the cause of infertility.
    15. Willing to accept transfer of a single good-quality blastocyst (double blastocyst transfer is allowed if no good-quality blastocyst is available).
    1. Formulario de consentimiento informado de la participante firmado antes de emprender cualquier actividad relacionada con el ensayo.
    2. Formulario de consentimiento informado de los padres firmado antes del inicio de la estimulación en el ensayo.
    3. En buen estado de salud física y mental a juicio del investigador.
    4. Mujeres premenopáusicas de entre 18 y 42 años. Las mujeres deben tener al menos 18 años (incluido el día del 18.º cumpleaños) y no más de 42 (hasta el día anterior al 43.er cumpleaños) cuando firmen el consentimiento informado.
    5. Mujeres infértiles diagnosticadas con infertilidad tubárica, infertilidad idiopática, endometriosis en estadio I/II o con parejas diagnosticadas con infertilidad por factor masculino, elegibles para fecundación in vitro (FIV) y/o inyección intracitoplasmática de espermatozoides (IICE) utilizando semen fresco o congelado eyaculado de la pareja masculina o de un donante de semen.
    6. Infertilidad durante al menos 1 año antes de la selección en las mujeres <35 años o durante al menos 6 meses en las mujeres ≥35 años (no aplicable en caso de infertilidad tubárica o infertilidad por factor masculino grave).
    7. Niveles séricos de la hormona foliculoestimulante (FSH) en la fase folicular temprana (día 2-4 del ciclo) entre 1 y 15 UI/l (resultados obtenidos en los 3 meses anteriores al inicio de la estimulación en el ensayo).
    8. Desarrollo folicular con ≥3 folículos con un diámetro ≥17 mm y <20 folículos con un diámetro ≥12 mm observados en la ecografía transvaginal al final de la estimulación en el ciclo de ensayo.
    9. No se han iniciado más de dos ciclos de estimulación ovárica controlada, con independencia del resultado (teniendo en cuenta los criterios de exclusión 3, 4 y 5).
    10. Ciclos menstruales regulares de 24-35 días (ambos inclusive), presuntamente ovulatorios.
    11. Histerosalpingografía, histeroscopia, ecografía por infusión salina o ecografía transvaginal que documenten un útero compatible con la función normal esperada (por ejemplo, sin indicios de fibromas uterinos clínicamente interferentes definidos como fibromas submucosos o intramurales de más de 3 cm de diámetro, sin pólipos y sin anomalías estructurales congénitas que se asocien con una disminución de la posibilidad de embarazo) en el año anterior al inicio de la estimulación en el ensayo.
    12. Ecografía transvaginal que documente la presencia y la adecuada visualización de ambos ovarios, sin indicios de anomalía significativa (por ejemplo, ovarios agrandados que contraindiquen el uso de gonadotropinas) y anexos normales (por ejemplo, sin hidrosalpinge) en el año anterior al inicio de la estimulación en el ensayo. Ambos ovarios deben ser accesibles para la extracción de los ovocitos.
    13. Resultado negativo en las pruebas séricas de anticuerpos contra el antígeno de superficie de la hepatitis B (HBsAg), el virus de la hepatitis C (VHC) y el virus de la inmunodeficiencia humana (VIH) en el año anterior al inicio de la estimulación en el ensayo.
    14. Estar dispuesta a aceptar la IICE con independencia de la causa de la infertilidad.
    15. Estar dispuesta a aceptar la transferencia de un solo blastocisto de buena calidad (se permite la transferencia doble de blastocistos si no se dispone de un blastocisto de buena calidad).
    E.4Principal exclusion criteria
    1. Known polycystic ovary syndrome (PCOS) associated with anovulation or known endometriosis stage III-IV
    2. Considered unsuitable for controlled ovarian stimulation with a starting dose of 150 or 225 IU/day highly purified human menopausal gonadotropin (HP-hMG), as judged by the investigator.
    3. Poor response in a previous controlled ovarian stimulation cycle using a gonadotropin starting dose of 150 IU/day or higher. Poor response is defined as <4 oocytes retrieved, or cycle cancellation prior to oocyte retrieval due to inadequate follicular development.
    4. Excessive ovarian response in a previous controlled ovarian stimulation cycle for IVF/ICSI using a daily FSH/hMG dose of <225 IU, defined as ≥25 oocytes retrieved or cycle cancellation prior to oocyte retrieval due to excessive ovarian response, including risk of ovarian hyperstimulation syndrome (OHSS).
    5. One or more follicles ≥10 mm (including cysts) observed on the transvaginal ultrasound prior to start of ovarian stimulation on stimulation day 1 (puncture of cysts is allowed prior to start of stimulation).
    6. Known history of recurrent miscarriage (defined as three consecutive losses after ultrasound confirmation of pregnancy and before week 24 of pregnancy, excluding ectopic pregnancy).
    7. Known history of recurrent miscarriage (defined as three consecutive losses after ultrasound confirmation of pregnancy and before week 24 of pregnancy, excluding ectopic pregnancy).
    8. Known abnormal karyotype of subject or of her partner/sperm donor, as applicable, depending on source of sperm used for insemination in this trial. In case partner sperm will be used and the sperm production is severely impaired (concentration <1 million/mL), normal karyotype, including no Y-chromosome microdeletion, must be documented.
    9. Any known clinically significant systemic disease (e.g. insulin-dependent diabetes).
    10. Known inherited or acquired thrombophilia disease.
    11. Known active arterial or venous thromboembolism or severe thrombophlebitis, or a history of these events.
    12. Any known endocrine or metabolic abnormalities (pituitary, adrenal, pancreas, liver, or kidney) with the exception of controlled thyroid function disease.
    13. Known presence of anti-hCG antibodies (based on the information available in the subject’s medical records; i.e. not based on the anti-hCG antibody analyses conducted in the trial).
    14. Known tumours of the ovary, breast, uterus, adrenal gland, pituitary, or hypothalamus which would contraindicate the use of gonadotropins.
    15. Known impairment of renal or hepatic function.
    16. Any abnormal finding of clinical chemistry and haematology at screening or vital signs at randomisation, which is judged clinically relevant by the investigator and/or requires intervention.
    17. Currently breast-feeding.
    18. Undiagnosed vaginal bleeding.
    19. Known abnormal cervical cytology of clinical significance observed within 3 years prior to start of stimulation in the trial (unless the clinical significance has been resolved).
    20. Findings at the gynaecological examination at screening which preclude gonadotropin stimulation or are associated with a reduced chance of pregnancy, e.g. congenital uterine abnormalities or retained intrauterine device.
    21. Pregnancy (negative urinary pregnancy tests must be documented at screening and prior to start of stimulation) or contraindication to pregnancy.
    22. Known current active pelvic inflammatory disease.
    23. Use of fertility modifiers during the last menstrual cycle before start of stimulation in the trial, including dehydroepiandrosterone (DHEA) or cycle programming with oral contraceptives, progestogen or estrogen preparations.
    24. Use of hormonal preparations (except for thyroid medication) during the last menstrual cycle before start of stimulation in the trial.
    25. Known history of chemotherapy (except for gestational conditions) or radiotherapy.
    26. Current or past (1 year prior to start of stimulation in the trial) abuse of alcohol or drugs, and/or current (last month) intake of more than 14 units of alcohol per week.
    27. Current or past (90 days prior to start of stimulation in the trial) smoking habit of more than 10 cigarettes per day.
    28. Hypersensitivity to any active ingredient or excipients in the medicinal products used in the trial.
    29. Previous participation in the trial (i.e. re-screening is not allowed).
    30. Use of any non-registered investigational drugs during the last 90 days prior to start of stimulation in the trial.
    1.Síndrome de ovario poliquístico (SOP) conocido asociado a anovulación o endometriosis conocida en estadio III-IV (American Society for Reproductive Medicine, 2012).
    2.Consideradas inadecuadas para la estimulación ovárica controlada con una dosis inicial de 150 o 225 UI/día de gonadotropina menopáusica humana altamente purificada (HP-hMG), a juicio del investigador.
    3.Mala respuesta en un ciclo de estimulación ovárica controlada anterior utilizando una dosis inicial de gonadotropina de 150 UI/día o superior. La respuesta deficiente se define como <4 ovocitos extraídos, o la cancelación del ciclo antes de la extracción de los ovocitos debido a un desarrollo folicular inadecuado.
    4.Respuesta ovárica excesiva en un ciclo previo de estimulación ovárica controlada para FIV/IICE utilizando una dosis diaria de FSH/hMG de ≤225 UI, definida como ≥25 ovocitos extraídos o cancelación del ciclo antes de la extracción de los ovocitos debido a una respuesta ovárica excesiva, incluido el riesgo de síndrome de hiperestimulación ovárica (SHO).
    5.SHO grave en un ciclo previo de estimulación ovárica controlada.
    6.Uno o más folículos ≥10 mm (incluidos quistes) observados en la ecografía transvaginal antes del inicio de la estimulación ovárica el día 1 de la estimulación (se permite la punción de quistes antes del inicio de la estimulación).
    7.Antecedentes conocidos de abortos espontáneos recurrentes (definidos como tres pérdidas consecutivas tras la confirmación ecográfica del embarazo y antes de la semana 24 de gestación, excluido el embarazo ectópico).
    8.Cariotipo anormal conocido de la mujer o de su pareja/donante de semen, según corresponda, según la procedencia del semen utilizado para la inseminación en este ensayo. En el caso de que se utilice el semen de la pareja y la producción de semen esté muy deteriorada (concentración <1 millón/ml), se debe documentar un cariotipo normal, incluida la ausencia de microdeleción del cromosoma Y.
    9.Cualquier enfermedad sistémica clínicamente significativa conocida (por ejemplo, diabetes insulinodependiente).
    10.Enfermedad trombofílica hereditaria o adquirida conocida.
    11.Tromboembolia arterial o venosa activa conocida o tromboflebitis grave, o antecedentes de estos acontecimientos.
    12.Cualquier anomalía endocrina o metabólica conocida (hipofisaria, suprarrenal, pancreática, hepática o renal), con la excepción de enfermedad de la función tiroidea controlada.
    13.Presencia conocida de anticuerpos anti-hCG (según la información disponible en la historia clínica de la mujer; es decir, no basada en los análisis de anticuerpos anti-hCG efectuados en el ensayo).
    14.Tumores conocidos de ovario, mama, útero, glándula suprarrenal, hipófisis o hipotálamo que contraindiquen el uso de gonadotropinas.
    15.Deterioro conocido de la función renal o hepática.
    16.Cualquier hallazgo anormal de bioquímica clínica y hematología en el momento de la selección o de las constantes vitales en el momento de la aleatorización, que el investigador considere de importancia clínica y/o que requiera una intervención.
    17.Actualmente está amamantando.
    18.Sangrado vaginal no diagnosticado.
    19.Citología cervical anormal conocida de importancia clínica observada en los 3 años anteriores al inicio de la estimulación en el ensayo (a menos que la importancia clínica se haya resuelto).
    20.Hallazgos en el examen ginecológico de la selección que impidan la estimulación con gonadotropinas o se asocien a una menor probabilidad de embarazo, por ejemplo, anomalías uterinas congénitas o retención de un dispositivo intrauterino.
    21.Embarazo (se deben documentar las pruebas de embarazo en orina negativas en el momento de la selección y antes del inicio de la estimulación) o contraindicación para el embarazo.
    22.Enfermedad inflamatoria pélvica activa conocida.
    23.Uso de modificadores de la fertilidad durante el último ciclo menstrual antes del inicio de la estimulación en el ensayo, incluida la dehidroepiandrosterona (DHEA) o la programación del ciclo con anticonceptivos orales, preparados de progestágenos o estrógenos.
    24.Uso de preparados hormonales (excepto medicación tiroidea) durante el último ciclo menstrual antes del inicio de la estimulación en el ensayo.
    25.Antecedentes conocidos de quimioterapia (excepto en caso de afecciones gestacionales) o radioterapia.
    26.Abuso actual o pasado (1 año antes del inicio de la estimulación en el ensayo) de alcohol o drogas, y/o ingesta actual (último mes) de más de 14 unidades de alcohol por semana.
    27. Consumo actual o pasado (90 días antes del inicio de la estimulación en el ensayo) de más de 10 cigarrillos al día.
    28.Hipersensibilidad a cualquier principio activo o excipiente de los medicamentos utilizados en el ensayo.
    29.Participación previa en el ensayo (es decir, no se permite una repetición de la selección).
    30.Uso de cualquier medicamento en investigación no registrado durante los 90 días previos al inicio de la estimulación en el ensayo.
    E.5 End points
    E.5.1Primary end point(s)
    Number of metaphase II (MII) oocytes
    Número de ovocitos en metafase II (MII)
    E.5.1.1Timepoint(s) of evaluation of this end point
    36 hours (+/- 2h) after triggering of final follicular maturation
    36 horas (+/- 2h) después del desencadenamiento de la maduración folicular final
    E.5.2Secondary end point(s)
    1. Secondary Efficacy Endpoints
    1.1 Number of oocytes retrieved
    1.2 Number of fertilised (2 pronuclei) oocytes
    1.3 Number and quality of embryos
    1.4 Number and quality of blastocysts
    1.5 Serum hormone concentrations of progesterone, 17-OH-progesterone, estradiol, follicle-stimulating hormone (FSH), and luteinising hormone (LH)
    1.6 Positive βhCG (positive serum βhCG test)
    1.7 Clinical pregnancy (at least one gestational sac)
    1.8 Vital pregnancy (at least one intrauterine gestational sac with fetal heart beat)
    1.9 Ongoing pregnancy (at least one intrauterine viable fetus)

    2. Secondary Pharmacokinetics Endpoint
    2.1 Serum hCG concentrations

    3. Secondary Safety Endpoints
    3.1 Ovarian hyperstimulation syndrome (OHSS), overall and by grade and severity
    3.2 Injection site reactions (redness, pain, itching, swelling, and bruising) assessed by the
    subject following administration of investigational medicinal product (IMP)
    3.3 Treatment-induced anti-hCG antibodies, overall as well as with neutralising capacity
    3.4 Multi-fetal gestation, biochemical pregnancy, spontaneous abortion, ectopic pregnancy
    (with and without medical/surgical intervention), and vanishing twins

    4. Exploratory Endpoint
    4.1 Biomarkers of oocyte maturation and/or OHSS in follicular fluid and granulosa cells
    1.Criterios secundarios de valoración de la eficacia
    1.1 Número de ovocitos extraídos
    1.2 Número de ovocitos fecundados (2 pronúcleos)
    1.3 Número y calidad de los embriones en el día 3 tras la extracción de los ovocitos
    1.4 Número y calidad de los blastocistos en el día 5 tras la extracción de los ovocitos
    1.5 Concentraciones hormonales séricas de progesterona, 17-OH-progesterona, estradiol, hormona foliculoestimulante (FSH) y hormona luteinizante (LH) al final de la estimulación, al día siguiente del desencadenamiento, en el momento de la extracción de los ovocitos, el día 5 después de la extracción de los ovocitos (transferencia), el día 7-9 después de la extracción de los ovocitos (fase lútea media) y a los 13-15 días después de la transferencia.
    1.6 βhCG positiva (prueba de βhCG positiva en suero 13-15 días después de la transferencia)
    1.7 Embarazo clínico (al menos un saco gestacional 5-6 semanas después de la transferencia)
    1.8 Embarazo vital (al menos un saco gestacional intrauterino con latidos fetales 5-6 semanas después de la transferencia)
    1.9 Embarazo en curso (al menos un feto intrauterino viable 10-11 semanas después de la transferencia)

    2. Criterio secundario de valoración de la farmacocinética
    2.1 Concentraciones séricas de hCG

    3. Criterios secundarios de valoración de la seguridad
    3.1 Síndrome de hiperestimulación ovárica (SHO), en general y por momento, grado e intensidad
    3.2 Reacciones en el lugar de la inyección (enrojecimiento, dolor, picor, hinchazón y hematoma) evaluadas por la participante tras la administración del medicamento en investigación (MI)
    3.3 Anticuerpos anti-hCG inducidos por el tratamiento, tanto en general como con capacidad neutralizante
    3.4 Gestación multifetal, embarazo bioquímico, aborto espontáneo, embarazo ectópico (con y sin intervención médica/quirúrgica) y reabsorción fetal

    4. Criterio de valoración exploratorio
    4.1 Biomarcadores de la maduración de los ovocitos y/o del síndrome de hiperestimulación ovárica en el líquido folicular y en las células de la granulosa
    E.5.2.1Timepoint(s) of evaluation of this end point
    1.3 on day 3 after oocyte retrieval
    1.4 on day 5 after oocyte retrieval
    1.5 at end-of-stimulation, the day after triggering, at oocyte retrieval, on day 5 after oocyte retrieval (transfer), on day 7-9 after oocyte retrieval (mid-luteal phase), and 13-15 days after transfer
    1.6 13-15 days after transfer
    1.7 5-6 weeks after transfer
    1.8 5-6 weeks after transfer
    1.9 10-11 weeks after transfer
    2.1 at end-of-stimulation, the day after triggering, at oocyte retrieval, on day 5 after oocyte retrieval (transfer), and on day 7-9 after oocyte retrieval (mid-luteal phase)
    3. Secondary Safety Endpoints ongoing throughout the trial
    1.3 el día 3 después de la extracción de ovocitos
    1.4 el día 5 después de la extracción de ovocitos
    1.5 al final de la estimulación, el día después de la activación, en la recuperación de ovocitos, el día 5 después de la recuperación de ovocitos (transferencia), el día 7-9 después de la recuperación de ovocitos (fase lútea media) y 13-15 días después de la transferencia
    1.6 13-15 días después de la transferencia
    1.7 5-6 semanas después de la transferencia
    1.8 5-6 semanas después de la transferencia
    1.9 10-11 semanas después de la transferencia

    *para el resto consultar el protocolo
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind Yes
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial5
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA15
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The end of the trial is defined as the date of LPLV, i.e the end-of-trial visit of the last subject
    The sponsor shall submit and end-of-trial notification to the regulatory authorities and the concerned ethics committees in the participating countries, when the last data in the pregnancy follow-up period has been collected in all participating countries, i.e when the last 4 week follow-up data on the neonates have been collected.
    El final del ensayo se define como la fecha de LPLV, es decir, la visita de fin de ensayo del último sujeto
    El promotor deberá enviar una notificación de finalización del ensayo a las autoridades reguladoras y a los comités de ética correspondientes de los países participantes, cuando se hayan recopilado los últimos datos del período de seguimiento del embarazo en todos los países participantes.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months4
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months4
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 500
    F.1.3Elderly (>=65 years) No
    F.1.3.1Number of subjects for this age range: 0
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male No
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception Yes
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state220
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 500
    F.4.2.2In the whole clinical trial 500
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    If the subject does not achieve a pregnancy in the fresh cycle, the subject has the option of using the frozen fertilised egg(s) in a later cycle, should the subject choose to undergo the procedure for frozen cycles at the subjects own expense.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2022-08-04
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-07-26
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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