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Trial registered on ANZCTR
Registration number
ACTRN12621001699853
Ethics application status
Approved
Date submitted
24/09/2021
Date registered
10/12/2021
Date last updated
10/12/2021
Date data sharing statement initially provided
10/12/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
The ENHANCE study. Can a daily supplement improve egg quality?
The effects of NR (Nicotinamide riboside) supplementation on the egg quality of women of advanced age undergoing IVF: a randomised placebo-controlled double-blind proof of concept clinical trial
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Scientific title
The ENHANCE study. Can a daily supplement improve egg quality?
The effects of NR (Nicotinamide riboside) supplementation on the egg quality of women of advanced age undergoing IVF: a randomised placebo-controlled double-blind proof of concept clinical trial
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Secondary ID [1]
304110
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Nil known
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Universal Trial Number (UTN)
U1111-1269-7929
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Infertility
323713
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Poor ovarian reserve
323715
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Condition category
Condition code
Reproductive Health and Childbirth
321248
321248
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0
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Fertility including in vitro fertilisation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients who are eligible to join the study will be randomised into three groups. Women will be using NR - Nicotinamide Riboside (TRU NIAGEN - TGA listed ARTG number 328365), as oral capsules, at the dosage of 250mg, 1000mg or placebo once a day for six weeks before the trigger (36 hours before the egg collection) in an IVF treatment cycle. As a strategy to monitor adherence to the intervention, the research nurse will call each participant after 14 days of medication use to check for compliance. In addition, after the participant’s first clinic visit, (approximately 28 days since commencing the study medication), the participant will be seen by research staff to count their study medication to check for compliance.
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Intervention code [1]
321781
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Treatment: Drugs
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Comparator / control treatment
Control: Placebo capsules (microcrystalline cellulose)
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Number of day 5 blastocysts per patient, assessed by study fertility specialist
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Assessment method [1]
329032
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Timepoint [1]
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Seven days post conclusion of intervention
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Secondary outcome [1]
401229
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Number of oocytes retrieved, assessed by study fertility specialist
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Assessment method [1]
401229
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Timepoint [1]
401229
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Two days post conclusion of intervention
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Secondary outcome [2]
401230
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Final estradiol level - serum assay
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Assessment method [2]
401230
0
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Timepoint [2]
401230
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Six weeks post commencement of intervention
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Secondary outcome [3]
401231
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Fertilisation rates, calculated as the percentage of oocytes that turn into two pronuclei after a fertilisation procedure. This outcome will be assessed by study fertility specialist.
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Assessment method [3]
401231
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Timepoint [3]
401231
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Three days post conclusion of intervention
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Secondary outcome [4]
401232
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Number of embryos surviving to D3, defined by the number of embryos that survives in culture medium for at least 3 days, which will be assessed by the study fertility specialist.
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Assessment method [4]
401232
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Timepoint [4]
401232
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Five days post conclusion of intervention
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Secondary outcome [5]
401233
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Clinical pregnancy rates - gestational sac with fetal heart beat diagnosed by transvaginal ultrasound at 6 weeks of pregnancy
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Assessment method [5]
401233
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Timepoint [5]
401233
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Ten weeks post conclusion of intervention
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Secondary outcome [6]
401234
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Pregnancy outcomes - we will record APGAR scores as surrogate for health of the child. Data will be collected from medical records.
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Assessment method [6]
401234
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Timepoint [6]
401234
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Forty four to forty six weeks post conclusion of intervention. This is a one-time assessment (at the day of birth).
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Secondary outcome [7]
401235
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NR safety - analysed through a composite of side effects (which will be registered by the research team firstly within 48 hours of commencement of medication to check for any adverse events, then after 14 days, then on each visit during ovarian stimulation that will occur every 2-3 days) and pregnancy outcomes. Data will be collected from the audit of study records.
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Assessment method [7]
401235
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Timepoint [7]
401235
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From day one of intervention until birth if the patient conceives as a result of the treatment.
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Secondary outcome [8]
401236
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Bioavailability of NAD in blood - Serum assay
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Assessment method [8]
401236
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Timepoint [8]
401236
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Six weeks post commencement of intervention and two days post conclusion of intervention, respectively
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Secondary outcome [9]
401237
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Oocyte quality - analysed as a composite at a molecular level (samples of cumulus cells and follicular fluid will be obtained) and through non-invasive imaging of oocytes using polarised light microscopy and deep radiomic imaging
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Assessment method [9]
401237
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Timepoint [9]
401237
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Two days post conclusion of intervention
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Secondary outcome [10]
402391
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Pregnancy outcomes - we will record birth weight at day of birth. Data will be collected from medical records.
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Assessment method [10]
402391
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Timepoint [10]
402391
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Forty four to forty six weeks post conclusion of intervention. This is a one-time assessment (at the day of birth).
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Secondary outcome [11]
402392
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Bioavailability of NAD in follicular fluid - Serum assay
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Assessment method [11]
402392
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Timepoint [11]
402392
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Six weeks post commencement of intervention and two days post conclusion of intervention, respectively
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Eligibility
Key inclusion criteria
Female patients undergoing IVF aged greater than or equal to 36 years at the time of randomisation
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Minimum age
36
Years
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Maximum age
42
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Consumption of herbal medicine or additional supplements except for preconception multivitamins
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer (RedCap)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
Participants are randomly allocated to receive either 250mg or 1000mg of NR or placebo
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Phase
Phase 2 / Phase 3
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Descriptive statistics will be presented by mean, SD, maximum and minimum for continuous variables, and the number of cases (n) and rate (%) for dichotomous variables. To explore the association between the number of retrieved oocytes and the number of blastocysts, univariable and multivariable regression analyses will be used. This study is a proof-of-concept trial to evaluate whether there is any evidence of the benefit of NR compared with the placebo.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
15/12/2021
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
308491
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University
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Name [1]
308491
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University of New South Wales - UNSW
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Address [1]
308491
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DVC Research Office, UNSW, Sydney, NSW, 2052, Australia
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Country [1]
308491
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Australia
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Primary sponsor type
University
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Name
University of New South Wales - UNSW
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Address
DVC Research Office, UNSW, Sydney, NSW, 2052, Australia
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Country
Australia
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Secondary sponsor category [1]
310763
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None
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Name [1]
310763
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Address [1]
310763
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Country [1]
310763
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Other collaborator category [1]
281991
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Commercial sector/Industry
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Name [1]
281991
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CERP - ChromaDex External Research Program
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Address [1]
281991
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10005 Muirlands Blvd., Suite G - Irvine, CA 92618 USA
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Country [1]
281991
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United States of America
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308448
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SESLHD - HREC / Research Ethics and Governance Office
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Ethics committee address [1]
308448
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District Executive Unit, Level4 The Sutherland Hospital & Community Health Service Cnr The Kingsway & Kareena Road Caringbah - NSW 2229
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Ethics committee country [1]
308448
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Australia
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Date submitted for ethics approval [1]
308448
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Approval date [1]
308448
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20/09/2021
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Ethics approval number [1]
308448
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Summary
Brief summary
The Enhance study is a randomised placebo-controlled double-blind proof of concept clinical trial to analyse whether using a daily supplement can improve egg quality. Women between the age of 36 and 42 requiring IVF trying to conceive will be randomised for the use of NR at the dosage of 250mg, 1000mg, or placebo, once a day for six weeks before the trigger (36 hours before the egg collection) in an IVF cycle. A primary outcome will be analysing the number of day 5 blastocysts and secondary outcomes: number of oocytes retrieved, final estradiol level, fertilisation rates, number of embryos surviving to D3, pregnancy rates and outcomes, and NR safety. We will also be evaluating the bioavailability of NAD in blood and follicular fluid and oocyte quality.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
110734
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Prof William Ledger
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Address
110734
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School of Women's & Children's Health, University of New South Wales Level 1, Royal Hospital for Women, Barker Street (Locked Bag 2000), RANDWICK, NSW 2031
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Country
110734
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Australia
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Phone
110734
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+61 02 9382 6515
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Fax
110734
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Email
110734
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[email protected]
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Contact person for public queries
Name
110735
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Galina Lazareva
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Address
110735
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Level 1, Royal Hospital for Women Barker Street, RANDWICK NSW 2031
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Country
110735
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Australia
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Phone
110735
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+61 02 9382 6515
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Fax
110735
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Email
110735
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[email protected]
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Contact person for scientific queries
Name
110736
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Robert Gilchrist
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Address
110736
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School of Women's & Children's Health, University of New South Wales Level 1, Royal Hospital for Women, Barker Street (Locked Bag 2000), RANDWICK, NSW 2031
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Country
110736
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Australia
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Phone
110736
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+61 02 9065 2241
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Fax
110736
0
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Email
110736
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
13299
Informed consent form
The informed consent form will be handled to the p...
[
More Details
]
381919-(Uploaded-21-09-2021-17-38-12)-Study-related document.pdf
13300
Clinical study report
The trial results will be published in a high impa...
[
More Details
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Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF