NCT02630485

Brief Summary

The purpose of this study is to help women with PCOS to improve their symptoms and ovulation rate through a lifestyle intervention program which introduces a specific diet, a physical activity regimen and mindfulness exercises to improve psychological well-being and overall health.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
240

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Dec 2015

Typical duration for not_applicable

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 30, 2015

Completed
1 day until next milestone

Study Start

First participant enrolled

December 1, 2015

Completed
14 days until next milestone

First Posted

Study publicly available on registry

December 15, 2015

Completed
2.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2018

Completed
5 months until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2018

Completed
Last Updated

December 15, 2015

Status Verified

December 1, 2015

Enrollment Period

2.2 years

First QC Date

November 30, 2015

Last Update Submit

December 10, 2015

Conditions

Keywords

Randomized Controlled Trial

Outcome Measures

Primary Outcomes (2)

  • Ovulation Occurence

    Ovulation is the primary outcome and expressed as any ovulation (categorical "yes" or "no") during the 12-week (84-day) study. This length allows observation of 3 potential ovulatory cycles. The upper limit of a normal ovulatory cycle is 35 days, so to accommodate for this, documentation of ovulation with a progesterone test may extend to the end of week 14.

    12 weeks

  • Ovulation Frequency

    Ovulation is the primary outcome can be expressed in according to frequency (nominal "0", "1", "2, or "3") during the 12-week (84-day) study. This length allows observation of 3 potential ovulatory cycles. The upper limit of a normal ovulatory cycle is 35 days, so to accommodate for this, documentation of ovulation with a progesterone test may extend to the end of week 14.

    12 weeks

Secondary Outcomes (5)

  • Conception

    12 weeks

  • Stress

    12 weeks

  • Anxiety

    12 weeks

  • Depression

    12 weeks

  • Quality of Life

    12 weeks

Study Arms (4)

Graceful Lifestyle Changes & MYO

EXPERIMENTAL

The 12-week lifestyle intervention will incorporate three lifestyle changes: a low-glycemic diet, increased exercise, and stress reduction through meditation and mindfulness. In addition, this group will take myo-inositol (6 grams in juice or water every morning).

Behavioral: Graceful Lifestyle ChangesDietary Supplement: Myo-inositol

Graceful Lifestyle Changes

EXPERIMENTAL

The 12-week lifestyle intervention will incorporate three lifestyle changes: a low-glycemic diet, increased exercise, and stress reduction through meditation and mindfulness. In addition, this group will take a white powder placebo (6 grams in juice or water every morning).

Behavioral: Graceful Lifestyle Changes

Letrozole & MYO

PLACEBO COMPARATOR

The women assigned to the fertility medication group will be prescribed letrozole. The initial dose will be 5 mg daily for five days and the dose can be increased by 2.5 mg to a total daily dose of 7.5 mg if necessary depending on ovulatory response, as in clinical practice. This treatment regimen will continue for three cycles (approximately the same period of time as the treatment group) or until pregnancy is achieved. In addition, this group will take myo-inositol (6 grams in juice or water every morning).

Dietary Supplement: Myo-inositolDrug: Letrozole

Letrozole

PLACEBO COMPARATOR

The women assigned to the fertility medication group will be prescribed letrozole. The initial dose will be 5 mg daily for five days and the dose can be increased by 2.5 mg to a total daily dose of 7.5 mg if necessary depending on ovulatory response, as in clinical practice. This treatment regimen will continue for three cycles (approximately the same period of time as the treatment group) or until pregnancy is achieved. In addition, this group will take a white powder placebo (6 grams in juice or water every morning).

Drug: Letrozole

Interventions

Participants will be educated in small groups of 8-10. A wellness booklet designed by physicians and researchers at Grace Fertility Centre will be provided.The target diet for our study is 45% carbohydrates and 55 grams of glycemic load. Participants will keep a 3-day food diary at baseline, 4, 8 and 12 weeks. Secondly, participants will be provided a pedometer and a goal to reach 10,000 steps a day. The third aspect of the program will be to decrease overall stress through mindfulness. Educational sessions will be held to teach the relaxation response and meditation techniques such as breathing and grounding exercises. Participants will be required to meditate for at least 20 minutes each day and record this.

Also known as: GLC
Graceful Lifestyle ChangesGraceful Lifestyle Changes & MYO
Myo-inositolDIETARY_SUPPLEMENT

Myo-inositol will be consumed in juice or water every morning (6 grams) for 12 weeks.

Also known as: Inositol, MYO
Graceful Lifestyle Changes & MYOLetrozole & MYO

Letrozole will be administered to patients. The initial dose will be 5 mg daily for five days and the dose can be increased by 2.5 mg to a total daily dose of 7.5 mg if necessary depending on ovulatory response, as in clinical practice. This treatment regimen will continue for three cycles (approximately the same period of time as the treatment group) or until pregnancy is achieved.

LetrozoleLetrozole & MYO

Eligibility Criteria

Age18 Years - 37 Years
Sexfemale
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • all women with PCOS trying to conceive who are between 18 and 37 years of age (PCOS will be defined using the Rotterdam criteria)

You may not qualify if:

  • women who have already began fertility treatment
  • women who are taking myo-inositol or have taken it in the past three months
  • women being treated for or who have a history of an eating disorder

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (10)

  • Barr S, Reeves S, Sharp K, Jeanes YM. An isocaloric low glycemic index diet improves insulin sensitivity in women with polycystic ovary syndrome. J Acad Nutr Diet. 2013 Nov;113(11):1523-1531. doi: 10.1016/j.jand.2013.06.347. Epub 2013 Aug 30.

    PMID: 23999280BACKGROUND
  • Barnard L, Ferriday D, Guenther N, Strauss B, Balen AH, Dye L. Quality of life and psychological well being in polycystic ovary syndrome. Hum Reprod. 2007 Aug;22(8):2279-86. doi: 10.1093/humrep/dem108. Epub 2007 May 30.

    PMID: 17537782BACKGROUND
  • Costantino D, Minozzi G, Minozzi E, Guaraldi C. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur Rev Med Pharmacol Sci. 2009 Mar-Apr;13(2):105-10.

    PMID: 19499845BACKGROUND
  • Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. 1997 Dec;18(6):774-800. doi: 10.1210/edrv.18.6.0318.

    PMID: 9408743BACKGROUND
  • Hutchison SK, Stepto NK, Harrison CL, Moran LJ, Strauss BJ, Teede HJ. Effects of exercise on insulin resistance and body composition in overweight and obese women with and without polycystic ovary syndrome. J Clin Endocrinol Metab. 2011 Jan;96(1):E48-56. doi: 10.1210/jc.2010-0828. Epub 2010 Oct 6.

    PMID: 20926534BACKGROUND
  • Ludwig DS, Kabat-Zinn J. Mindfulness in medicine. JAMA. 2008 Sep 17;300(11):1350-2. doi: 10.1001/jama.300.11.1350. No abstract available.

    PMID: 18799450BACKGROUND
  • Matchim Y, Armer JM, Stewart BR. Effects of mindfulness-based stress reduction (MBSR) on health among breast cancer survivors. West J Nurs Res. 2011 Dec;33(8):996-1016. doi: 10.1177/0193945910385363. Epub 2010 Oct 18.

    PMID: 20956583BACKGROUND
  • Papaleo E, Unfer V, Baillargeon JP, De Santis L, Fusi F, Brigante C, Marelli G, Cino I, Redaelli A, Ferrari A. Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction. Gynecol Endocrinol. 2007 Dec;23(12):700-3. doi: 10.1080/09513590701672405. Epub 2007 Oct 10.

    PMID: 17952759BACKGROUND
  • Unfer V, Carlomagno G, Dante G, Facchinetti F. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol. 2012 Jul;28(7):509-15. doi: 10.3109/09513590.2011.650660. Epub 2012 Feb 1.

    PMID: 22296306BACKGROUND
  • Cutler DA, Shaw AK, Pride SM, Bedaiwy MA, Cheung AP. A randomized controlled trial comparing lifestyle intervention to letrozole for ovulation in women with polycystic ovary syndrome: a study protocol. Trials. 2018 Nov 16;19(1):632. doi: 10.1186/s13063-018-3009-5.

MeSH Terms

Conditions

Polycystic Ovary SyndromeInfertility

Interventions

InositolLetrozole

Condition Hierarchy (Ancestors)

Ovarian CystsCystsNeoplasmsOvarian DiseasesAdnexal DiseasesGenital Diseases, FemaleFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesGenital DiseasesGonadal DisordersEndocrine System Diseases

Intervention Hierarchy (Ancestors)

Sugar AlcoholsAlcoholsOrganic ChemicalsCarbohydratesNitrilesTriazolesAzolesHeterocyclic Compounds, 1-RingHeterocyclic Compounds

Study Officials

  • Anthony P Cheung, MBBS MPH MBA

    Grace Fertility Centre & Reproductive Medicine

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Anthony P Cheung, MBBS MPH MBA

CONTACT

Dylan A Cutler, BSc

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 30, 2015

First Posted

December 15, 2015

Study Start

December 1, 2015

Primary Completion

March 1, 2018

Study Completion

August 1, 2018

Last Updated

December 15, 2015

Record last verified: 2015-12