Results of “fast track” clinical trial yield more live births and faster pregnancies.
Researchers in New England published results of a major clinical trial that compared an accelerated treatment strategy for couples with unexplained infertility compared to a conventional approach using injectable gonadotropins.
Results of the fast track and standard treatment trial (FASTT) indicate that the accelerated approach, which moved directly to in vitro fertilization (IVF) after three cycles of clomiphene/intrauterine insemination (IUI), resulted in a shorter time to pregnancy, more live births and lower costs.
About the FASTT trial
Couples who participated in the FASTT trial were randomly assigned to one of two groups. About half of the couples received a conventional treatment course. If they were not pregnant after three cycles of clomiphene/IUI, they received three cycles of gonadotropin injections/IUI using recombinant follicle-stimulating hormone (FSH).
If they still were not pregnant, they received up to six cycles of IVF. The other half of the couples received fast track treatment, beginning with three cycles of clomiphene/IUI. If they did not achieve pregnancy using the clomiphene citrate, they received up to six cycles of IVF. Both groups followed the same IVF protocol.
The study results
The study looked at the length of time between when each couple entered the trial and the date of a pregnancy resulting in a live birth. It also compared the average cost to deliver a live-born baby in each group. Other considerations were per-cycle pregnancy rates, per-couple pregnancy rates, and adverse events.
The pregnancy rate per cycle for couples using clomiphene citrate with insemination was 7.6%. The per cycle pregnancy rate with injectable gonadotropins with insemination was 9.8% and 30.7% with IVF. Over half of the couples who were fast-tracked were pregnant after 6 months of treatment whereas less than one-third of those who received conventional treatment were pregnant.
What this means to you
The fast track treatment appears to offer several advantages over conventional treatment for couples with unexplained infertility.
Your RMA fertility specialist can help you decide whether a fast track or conventional approach to fertility treatment—or other options, such as preimplantation genetic screening using CCS, or single-embryo transfer—might be right for you.
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