Ulipristal Acetate on Progesterone Levels and Glycodelin-A Endometrial Pattern

NCT ID: NCT01391845

Last Updated: 2011-07-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

16 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-07-31

Study Completion Date

2012-06-30

Brief Summary

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Controlled ovarian stimulation (COS) for FIV increases progesterone (P) and estradiol (E2) serum levels in supraphysiologic concentrations at the end of follicular phase. Elevated serum P levels leads to an accelerated endometrial maturation which interferes with the dialogue between embryo and endometrium. It has been reported that serum progesterone levels ≥ 1.5 ng/ml on the last day of COS are related to a significant decrease in the ongoing pregnancy rate following IVF cycles. Also, it has been reported a significant alteration in the endometrial gene expression profile related to P elevated levels.

Glycodelin-A is an immunomodulatory glycoprotein synthesized by luteal-phase endometrial epithelium and its expression seems to be related to the action of P. Because glycodelin-A has immunosuppressive activity, it may facilitate the process of implantation and the maintenance of pregnancy.

It is already know that ulipristal acetate (UPA) decrease serum P levels. The hypothesis of this study is that UPA is been able to modify P serum levels and glycodelin-A endometrial expression pattern on FSH/GnRH Antagonist cycles for FIV.

Detailed Description

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Controlled ovarian stimulation (COS) for FIV increases progesterone (P) and estradiol (E2) serum levels in supraphysiologic concentrations at the end of follicular phase. Elevated serum P levels leads to an accelerated endometrial maturation which interferes with the dialogue between embryo and endometrium. It has been reported that serum progesterone levels ≥ 1.5 ng/ml on the last day of COS are related to a significant decrease in the ongoing pregnancy rate following IVF cycles. Also, it has been reported a significant alteration in the endometrial gene expression profile related to P elevated levels.

Glycodelin-A is an immunomodulatory glycoprotein synthesized by luteal-phase endometrial epithelium and its expression seems to be related to the action of P. Because glycodelin-A has immunosuppressive activity, it may facilitate the process of implantation and the maintenance of pregnancy.

Objective: to evaluate the endometrial effect of Progesterone through Glycodelin-A expression pattern on women exposed or not to ulipristal acetate in GnRH Antagonist cycles using two different doses of FSH for ovarian controlled stimulation.

Methods: prospective controlled randomized study. It will be enrolling 16 oocytes donors from Oocyte Donation Program of PROAR (a Reproductive Center of Rosario, Argentina). On day 3 of menstrual cycle FSH serum levels and antral follicular count (AFC) will be measure. If those results fulfill with inclusions criteria, patients will be randomize for FSH 225UI or 300UI GnRH-Antagonist/ urinary FSH protocol. P serum levels will be measure every 48 hours since at least 1 follicle ≥14 mm will be achieve until at least 1 follicle reach 19mm of diameter. The next day of hCG administration a new P circulating will be measure and then the patient will be randomize trough opaque envelopes for receive 30mg of ulipristal acetate or placebo. An endometrial biopsy with Cornier´s Pipelle will be performing 3 and 5 days after hCG injection (hCG+3 and hCG+5 days) to evaluate endometrial dating and Glycodelin-A expression pattern.

Statistical analysis: nominal variables will be analyzing using t-Student test and the effect of ulipristal with ANOVA.

Conditions

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Infertility

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Blinding Strategy

SINGLE

Participants

Study Groups

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UPA, 300UI FSH

patients on COS with 300UI FSHu/GnRH Antagonist protocol and ulipristal acetate use

Group Type EXPERIMENTAL

ulipristal acetate

Intervention Type DRUG

30mg of ulipristal acetate orally the day of hCG injection in a unique dose

No UPA, 300FSH

patients on COS with 300UI FSHu/GnRH Antagonist protocol and without ulipristal acetate use

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

placebo orally in a unique dose the day of hCG injection

UPA, FSH 225

patients on COS with 225UI FSHu/GnRH Antagonist protocol and ulipristal acetate use

Group Type EXPERIMENTAL

ulipristal acetate

Intervention Type DRUG

ulipristal acetate 30mg orally in a unique dose the day of hCG administration

no UPA, FSH225

patients on COS with 225UI FSHu/GnRH Antagonist protocol and without ulipristal acetate use

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

placebo orally in a unique dose the day of hCG injection

Interventions

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ulipristal acetate

30mg of ulipristal acetate orally the day of hCG injection in a unique dose

Intervention Type DRUG

placebo

placebo orally in a unique dose the day of hCG injection

Intervention Type DRUG

ulipristal acetate

ulipristal acetate 30mg orally in a unique dose the day of hCG administration

Intervention Type DRUG

placebo

placebo orally in a unique dose the day of hCG injection

Intervention Type DRUG

Other Intervention Names

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UPA/FSH 300 No UPA/FSH 300 UPA/FSH225 no UPA/FSH225

Eligibility Criteria

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Inclusion Criteria

* Age \<35 years old
* FSH on day 3: \<12 UI/ml
* Antral follicular count ≥ 6 on day 3 of the cycle
* BMI: \<30 Kg/m2

Exclusion Criteria

* Hypothyroidism
* Hyperprolactinemia
* Kidney or liver disease
* Smoking
* Alcoholism
Minimum Eligible Age

21 Years

Maximum Eligible Age

35 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Programa de Asistencia Reproductiva de Rosario

OTHER

Sponsor Role lead

Responsible Party

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Programa de asistencia reproductiva de rosario (PROAR)

Principal Investigators

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Idelma Serpa, MD

Role: PRINCIPAL_INVESTIGATOR

PROAR-IUNIR

Carlos Morente, MD

Role: STUDY_CHAIR

Programa de Asistencia Reproductiva de Rosario

Locations

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PROAR (Programa de Asistencia Reproductiva de Rosario

Rosario, Santa Fe Province, Argentina

Site Status

Countries

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Argentina

Central Contacts

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Idelma Serpa, MD

Role: CONTACT

+54 0341 155668963

Idelma Serpa, MD

Role: CONTACT

Facility Contacts

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Idelma Serpa, MD

Role: primary

+54 0341 155668963

Other Identifiers

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ist1979

Identifier Type: -

Identifier Source: org_study_id

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