Assessment of multiple intrauterine gestations from ovarian stimulation (AMIGOS) trial: Baseline characteristics

Michael P. Diamond, Richard S. Legro, Christos Coutifaris, Ruben Alvero, Randal D. Robinson, Peter Casson, Gregory M. Christman, Joel Ager, Hao Huang, Karl R. Hansen, Valerie Baker, Rebecca Usadi, Aimee Seungdamrong, G. Wright Bates, R. Mitchell Rosen, Daniel Haisonleder, Stephen A. Krawetz, Kurt Barnhart, J. C. Trussell, Yufeng JinNanette Santoro, Esther Eisenberg, Heping Zhang, C. Bartlebaugh, W. Dodson, S. Estes, C. Gnatuk, R. Ladda, J. Ober, C. Easton, A. Hernandez, M. Leija, D. Pierce, R. Brzyski, A. Awonuga, L. Cedo, A. Cline, K. Collins, E. Puscheck, M. Singh, M. Yoscovits, K. Lecks, L. Martino, R. Marunich, A. Comfort, M. Crow, A. Hohmann, S. Mallette, Y. Smith, J. Randolph, S. Fisseha, M. Ringbloom, J. Tang, S. Mason, N. Di Maria, B. Laylor, L. Martinez, A. Solnica, A. Wojtczuk, M. Rhea, K. Turner, L. B. Craig, C. Zornes, M. R. Rodriguez, T. S. Hunt, Thomas Remble, Gloria Cheng, Lauri Green, Nikolaus Lenhart, D. Del Basso, M. Brennan, H. Kuang, Y. Li, P. Patrizio, L. Sakai, C. Song, H. Taylor, T. Thomas, Q. Yan, M. Zhang, C. Lamar, L. De Paolo, D. Guzick, A. Herring, J. Bruce Redmond, M. Thomas, P. Turek, J. Wactawski-Wende, R. Rebar, P. Cato, V. Dukic, V. Lewis, P. Schlegel, F. Witter

Research output: Contribution to journalArticle

Abstract

Objective: To identify baseline characteristics of women with unexplained infertility to determine whether treatment with an aromatase inhibitor will result in a lower rate of multiple gestations than current standard ovulation induction medications. Design: Randomized, prospective clinical trial. Setting: Multicenter university-based clinical practices. Patient(s): A total of 900 couples with unexplained infertility. Intervention(s): Collection of baseline demographics, blood samples, and ultrasonographic assessments. Main Outcome Measure(s): Demographic, laboratory, imaging, and survey characteristics. Result(s): Demographic characteristics of women receiving clomiphene citrate (CC), letrozole, or gonadotropins for ovarian stimulation were very consistent. Their mean age was 32.2 ± 4.4 years and infertility duration was 34.7 ± 25.7 months, with 59% primary infertility. More than one-third of the women were current or past smokers. The mean body mass index (BMI) was 27 and mean antimüllerian hormone level was 2.6; only 11 women (1.3%) had antral follicle counts of <5. Similar observations were identified for hormonal profiles, ultrasound characterization of the ovaries, semen parameters, and quality of life assessments in both male and female partners. Conclusion(s): The cause of infertility in the couples recruited to this treatment trial is elusive, as the women were regularly ovulating and had evidence of good ovarian reserve both by basal FSH, antimüllerian hormone levels, and antral follicle counts; the male partners had normal semen parameters. The three treatment groups have common baseline characteristics, thereby providing comparable patient populations for testing the hypothesis that use of letrozole for ovarian stimulation can reduce the rates of multiples from that observed with gonadotropin and CC treatment. Clinical Trial Registration Number: NCT 01044862.

Original languageEnglish (US)
Pages (from-to)962-973.e4
JournalFertility and sterility
Volume103
Issue number4
DOIs
StatePublished - Jan 1 2015

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Keywords

  • Aromatase inhibitors
  • Clomiphene citrate
  • Gonadotropins
  • Letrozole
  • Multiple gestations
  • Unexplained infertility

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Diamond, M. P., Legro, R. S., Coutifaris, C., Alvero, R., Robinson, R. D., Casson, P., Christman, G. M., Ager, J., Huang, H., Hansen, K. R., Baker, V., Usadi, R., Seungdamrong, A., Bates, G. W., Rosen, R. M., Haisonleder, D., Krawetz, S. A., Barnhart, K., Trussell, J. C., ... Witter, F. (2015). Assessment of multiple intrauterine gestations from ovarian stimulation (AMIGOS) trial: Baseline characteristics. Fertility and sterility, 103(4), 962-973.e4. https://doi.org/10.1016/j.fertnstert.2014.12.130